Provider Demographics
NPI:1174123491
Name:CHENEY, BETTY (RPH)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:CHENEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 STATE HIGHWAY 351
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-4766
Mailing Address - Country:US
Mailing Address - Phone:325-677-2191
Mailing Address - Fax:325-677-3349
Practice Address - Street 1:1650 STATE HIGHWAY 351
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-4766
Practice Address - Country:US
Practice Address - Phone:325-677-2191
Practice Address - Fax:325-677-3349
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist