Organization · Type 2 NPI

Baylor Scott & White Health Enterprises, Inc.

Community/Retail Pharmacy · Dallas, TX

NPI number 1770947798 Active

Practice location

3417 Gaston Ave Ste 195
Dallas, TX 75246-2016

Call (214) 818-1611 Map

Fax (214) 818-1612

Mailing address

PO Box 847670
Dallas, TX 75284-7670

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	30929 (TX)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

Another provider at this address

Kevin Lee Villamor Madelozo, PharmDPharmacist Dallas, TX NPI 1124809207

Other community/retail pharmacy providers in Dallas

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NPI record

NPI: 1770947798
Entity type: Organization (Type 2)
Issued: Apr 6, 2016
Last updated: Apr 24, 2025
Status: Active

Other names

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Baylor Scott & White Pharmacy #111 · doing business as
Baylor Scott & White Pharmacy #111 · doing business as

Authorized official

Tammy Cohen
President
(214) 865-3669

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1770947798

Baylor Scott & White Health Enterprises, Inc.'s National Provider Identifier is 1770947798, issued on Apr 6, 2016. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Dallas, TX. The record was last updated on Apr 24, 2025.