Provider Demographics
NPI:1558354613
Name:LIVERMAN, RAYMOND EUGENE JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:EUGENE
Last Name:LIVERMAN
Suffix:JR
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 1:2736 VALLEY VIEW LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-4925
Mailing Address - Country:US
Mailing Address - Phone:972-241-2012
Mailing Address - Fax:972-241-2149
Practice Address - Street 1:2736 VALLEY VIEW LN
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-4925
Practice Address - Country:US
Practice Address - Phone:972-241-2012
Practice Address - Fax:972-241-2149
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T98118Medicare UPIN
88X760Medicare ID - Type Unspecified