Provider Demographics
NPI:1366869927
Name:RAYNER, MATTHEW JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JAMES
Last Name:RAYNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 W NORTHWEST HWY
Mailing Address - Street 2:SUITE C-159
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-3460
Mailing Address - Country:US
Mailing Address - Phone:972-375-5568
Mailing Address - Fax:
Practice Address - Street 1:6211 W NORTHWEST HWY
Practice Address - Street 2:SUITE C-159
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-3460
Practice Address - Country:US
Practice Address - Phone:972-375-5568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12017111NN0400X, 111NN1001X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition