Provider Demographics
NPI:1043382906
Name:HUNTER, CHARLES RAY SR (OTR)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:RAY
Last Name:HUNTER
Suffix:SR
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:178 LAZY MDW
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6171
Mailing Address - Country:US
Mailing Address - Phone:210-394-0649
Mailing Address - Fax:210-735-9933
Practice Address - Street 1:12770 CIMARRON PATH
Practice Address - Street 2:SUITE 132
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3427
Practice Address - Country:US
Practice Address - Phone:210-394-0649
Practice Address - Fax:210-735-9922
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108049225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist