Provider Demographics
NPI:1972384048
Name:OLDFIELD, RAYGAN
Entity Type:Individual
Prefix:
First Name:RAYGAN
Middle Name:
Last Name:OLDFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 CROSSBOW LN
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-6364
Mailing Address - Country:US
Mailing Address - Phone:469-952-7197
Mailing Address - Fax:
Practice Address - Street 1:2725 BRYANT FARM RD
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409
Practice Address - Country:US
Practice Address - Phone:972-924-1813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121850235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist