Healthcare Provider Details

I. General information

NPI: 1134136914
Provider Name (Legal Business Name): CHARLES RAY OSBORN M.D. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 FERRIS AVE. SUITE D
WAXAHACHIE TX
75165-4824
US

IV. Provider business mailing address

PO BOX 2597
WAXAHACHIE TX
75168-8597
US

V. Phone/Fax

Practice location:
  • Phone: 972-938-7757
  • Fax: 972-938-0018
Mailing address:
  • Phone: 972-938-7757
  • Fax: 972-938-0018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberDC4497
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberDC4497
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: