Provider Demographics
NPI:1619691821
Name:EVERETT, BETHANY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:
Last Name:EVERETT
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 1:5040 S COULTER ST APT 1012
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-5429
Mailing Address - Country:US
Mailing Address - Phone:325-269-4507
Mailing Address - Fax:
Practice Address - Street 1:4701 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79110-2619
Practice Address - Country:US
Practice Address - Phone:806-373-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist