Provider Demographics
NPI:1811089162
Name:CHEYNE, GARLAND ROYCE (RPH)
Entity type:Individual
Prefix:MR
First Name:GARLAND
Middle Name:ROYCE
Last Name:CHEYNE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 ROCKDALE
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-4551
Mailing Address - Country:US
Mailing Address - Phone:817-645-2445
Mailing Address - Fax:817-645-5079
Practice Address - Street 1:502 N MAIN
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-3806
Practice Address - Country:US
Practice Address - Phone:817-645-2445
Practice Address - Fax:817-645-5079
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist