MEDICARE: DORRICK INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy
2	3336C0003X	Community/Retail Pharmacy	25184	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2099457	OTHER		PK

General Provider Information

NPI Number	:	1568574473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DORRICK INC

Provider Business Mailing Address
First Line	:	3008 LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-3520
Country	:	US
Telephone Number	:	713-742-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3008 LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-3520
Country	:	US
Telephone Number	:	713-742-8600
Fax Number	:	713-742-8615

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ENRIQUE CANTU
Credential	:
Telephone Number	:	713-742-8600

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/30/2015

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Directions to “DORRICK INC ” Practice Location

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