Provider Demographics
NPI:1245552942
Name:PAYTON, CHERIE'
Entity type:Individual
Prefix:
First Name:CHERIE'
Middle Name:
Last Name:PAYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 GENOA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2706
Mailing Address - Country:US
Mailing Address - Phone:806-687-9957
Mailing Address - Fax:888-456-2402
Practice Address - Street 1:6310 GENOA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2706
Practice Address - Country:US
Practice Address - Phone:806-687-9957
Practice Address - Fax:888-456-2402
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist