Provider Demographics
NPI:1356679328
Name:NEWSOME, CHERYL LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:WILLIAMS
Other - Last Name:NEWSOME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:5520 OLD ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-5007
Mailing Address - Country:US
Mailing Address - Phone:817-658-2890
Mailing Address - Fax:
Practice Address - Street 1:5900 W PLEASANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4427
Practice Address - Country:US
Practice Address - Phone:817-478-6041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35929183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist