Healthcare Provider Details

I. General information

NPI: 1083996375
Provider Name (Legal Business Name): DOCTORS SPECIALTY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 08/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 FREEPORT PKWY STE 110
IRVING TX
75063-1988
US

IV. Provider business mailing address

8600 FREEPORT PKWY STE 110A
IRVING TX
75063-2575
US

V. Phone/Fax

Practice location:
  • Phone: 469-906-2002
  • Fax: 469-454-1693
Mailing address:
  • Phone: 469-906-2002
  • Fax: 469-454-1693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number27846
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCHNEIDER
Title or Position: MANAGER
Credential:
Phone: 817-528-7197