Provider Demographics
NPI:1942593181
Name:ULRYCH, DOROTA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DOROTA
Middle Name:
Last Name:ULRYCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 BLUFFSTONE CV APT 5207
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7822
Mailing Address - Country:US
Mailing Address - Phone:224-489-3174
Mailing Address - Fax:
Practice Address - Street 1:799 LOUIS HENNA BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-7074
Practice Address - Country:US
Practice Address - Phone:512-310-7678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056271183500000X
TX65636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist