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General NPI Number Information
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NPI Number | 1609230812
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Entity Type | Individual
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Provider Name | EBONY N. RAYMOND D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 3105 W 15TH ST STE E
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City | PLANO
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State | TX
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Zip | 75075
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Country | US
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Telephone | 469-597-7281
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 961205
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City | FORT WORTH
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State | TX
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Zip | 76161-1205
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Country | US
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Telephone | 177-408-4008
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | S1243
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | S1243
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | S1243
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License Number State | TX
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