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	3336C0003X	Community/Retail Pharmacy	26112	TX

General Provider Information

NPI Number	:	1972748010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DORRICK INC.

Provider Business Mailing Address
First Line	:	10906 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-6316
Country	:	US
Telephone Number	:	281-477-6000
Fax Number	:	281-477-6001

Provider Business Practice Location Address
First Line	:	10906 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-6316
Country	:	US
Telephone Number	:	281-477-6000
Fax Number	:	281-477-6001

Authorized Official
Title or Position	:	PHARMACIST
Name	:	ENRIQUE CANTU
Credential	:	RPH
Telephone Number	:	281-477-7728

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	12/03/2008

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Directions to “DORRICK INC. ” Practice Location

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