Provider Demographics
NPI:1184917403
Name:DR. RAY L. NANNIS, P.C.
Entity type:Organization
Organization Name:DR. RAY L. NANNIS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:NANNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-671-2225
Mailing Address - Street 1:1750 N COLLINS BLVD STE 101B
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3551
Mailing Address - Country:US
Mailing Address - Phone:972-671-2225
Mailing Address - Fax:972-671-2226
Practice Address - Street 1:1750 N COLLINS BLVD STE 101B
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3551
Practice Address - Country:US
Practice Address - Phone:972-671-2225
Practice Address - Fax:972-671-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty