Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 3238 | OK |
N | 111NN1001X | Nutrition | CH 3157 | FL |
Y | 111NN1001X | Nutrition | DC2610 | TX |
NPI | 1467661702 |
---|---|
Provider Name | Ray Hammon |
First Address | Rowlett, TX 75088-4126 |
Second Address | Rowlett, TX 75088-4126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |