Provider Demographics
NPI:1083945091
Name:ZEWALK BETTS, CRESHAUN RENEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRESHAUN
Middle Name:RENEE
Last Name:ZEWALK BETTS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CRESHAUN
Other - Middle Name:RENEE
Other - Last Name:ZEWALK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4103 S GREAT SOUTHWEST PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3801
Mailing Address - Country:US
Mailing Address - Phone:972-602-8156
Mailing Address - Fax:972-602-3368
Practice Address - Street 1:4103 S GREAT SOUTHWEST PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3801
Practice Address - Country:US
Practice Address - Phone:972-602-8156
Practice Address - Fax:972-602-3368
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47120183500000X
AZS016760183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist