Basic Information
| Provider Information | |||||||||
| NPI: | 1902564461 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAYMON | ||||||||
| FirstName: | DONNIE | ||||||||
| MiddleName: | RAY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RT(R)RDMS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 HIGHLAND DR | ||||||||
| Address2: | |||||||||
| City: | RANSOM CANYON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 793662313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8066320363 | ||||||||
| FaxNumber: | 8068292545 | ||||||||
| Practice Location | |||||||||
| Address1: | 8602 PEACH AVE | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794047777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067451021 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2021 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085U0001X | 8697 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound |
No ID Information.