Provider Demographics
NPI:1760452510
Name:PERRY, RAYMOND B (DC)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:B
Last Name:PERRY
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 1:624 S SEGUIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-7647
Mailing Address - Country:US
Mailing Address - Phone:830-629-9909
Mailing Address - Fax:830-620-9073
Practice Address - Street 1:624 S SEGUIN AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7647
Practice Address - Country:US
Practice Address - Phone:830-629-9909
Practice Address - Fax:830-620-9073
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXUI0135Medicare UPIN
TX603333Medicare PIN