Provider Demographics
NPI:1629060637
Name:FREEMAN, RAY M (DC)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:M
Last Name:FREEMAN
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 1:2806 N NAVARRO ST
Mailing Address - Street 2:SUITE O
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3937
Mailing Address - Country:US
Mailing Address - Phone:361-578-9945
Mailing Address - Fax:361-578-9145
Practice Address - Street 1:2806 N NAVARRO ST
Practice Address - Street 2:SUITE O
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3937
Practice Address - Country:US
Practice Address - Phone:361-578-9945
Practice Address - Fax:361-578-9145
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC2508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001054801Medicaid
TX600810Medicare ID - Type Unspecified
TX001054801Medicaid