NPI age
19 years
Enumerated 2006-08-18
● Active Type 2 · Organization
Southland Legend Pharmacy
Southland Legend Pharmacy is 1 of 5625 pharmacy organizations in Texas.
Primary specialty
Pharmacy
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Benedetti
Pic
Last NPPES update
2025-09-11
Source: monthly bulk 2026-05
How this organization compares
Across 5625 active pharmacy providers in Texas.
NPI age
19 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 62% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
5201 S Broadway Ave, Ste 100
Tyler, TX 757033748
Mailing address
5201 S Broadway Ave, Ste 100
Tyler, TX 757033748
Authorized official
Doug Benedetti
Pic
📞 9035348218
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Ty Black, DDS Dentist NPI 1851448385
Specialties
-
Pharmacy PrimaryA 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...
-
PharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 144423 | |
| 01 | 4572093 | OTHER ID NUMBER-COMMERCIAL NUMBER |
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.