Provider Demographics
NPI:1346885837
Name:DRAYTON, D'MARCUS
Entity Type:Individual
Prefix:
First Name:D'MARCUS
Middle Name:
Last Name:DRAYTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 REESLING DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4246
Mailing Address - Country:US
Mailing Address - Phone:214-543-9831
Mailing Address - Fax:
Practice Address - Street 1:1311 REESLING DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4246
Practice Address - Country:US
Practice Address - Phone:214-543-9831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide