Provider Demographics
NPI:1417123357
Name:ONI, RAYMOND A (RN)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:A
Last Name:ONI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4326 MERIDEN CT
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-4337
Mailing Address - Country:US
Mailing Address - Phone:469-583-4564
Mailing Address - Fax:817-557-5434
Practice Address - Street 1:5626 CREEKHOLLOW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-2433
Practice Address - Country:US
Practice Address - Phone:469-583-4564
Practice Address - Fax:817-557-5434
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home