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General NPI Number Information
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NPI Number | 1669061875
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Entity Type | Individual
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Provider Name | BETHANY ROBERTS CPHT
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Gender | Female
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 313 SIDNEY BAKER ST S
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City | KERRVILLE
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State | TX
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Zip | 78028-5916
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Country | US
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Telephone | 830-792-5465
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Fax |
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Provider Business Mailing Address
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Address Line | 119 BRIARWOOD LN
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City | KERRVILLE
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State | TX
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Zip | 78028-9512
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Country | US
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Telephone | 830-928-5131
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 306089
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License Number State | TX
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