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General NPI Number Information
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NPI Number | 1053740951
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Entity Type | Individual
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Provider Name | RAY CHERNLY DAOM, L.AC.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2013
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 470 W HARWOOD RD
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City | HURST
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State | TX
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Zip | 76054
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Country | US
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Telephone | 817-498-8449
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Fax | 817-281-4829
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Provider Business Mailing Address
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Address Line | 470 W HARWOOD RD
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City | HURST
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State | TX
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Zip | 76054-2939
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Country | US
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Telephone | 817-498-8449
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Fax | 817-281-4829
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC01483
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License Number State | TX
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