Healthcare Provider Details

I. General information

NPI: 1467661702
Provider Name (Legal Business Name): RAY HAMMON D.C., N.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5429 LAKEVIEW PKWY
ROWLETT TX
75088-4126
US

IV. Provider business mailing address

5429 LAKEVIEW PKWY
ROWLETT TX
75088-4126
US

V. Phone/Fax

Practice location:
  • Phone: 972-463-1744
  • Fax:
Mailing address:
  • Phone: 972-463-1744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC2610
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCH 3157
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number3238
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: