Provider Demographics
NPI:1215042817
Name:WELD, RAYMOND EARL (DC)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:EARL
Last Name:WELD
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:PO BOX 1017
Mailing Address - Street 2:
Mailing Address - City:DALHART
Mailing Address - State:TX
Mailing Address - Zip Code:79022-1017
Mailing Address - Country:US
Mailing Address - Phone:806-249-4492
Mailing Address - Fax:
Practice Address - Street 1:604 LIBERAL
Practice Address - Street 2:
Practice Address - City:DALHART
Practice Address - State:TX
Practice Address - Zip Code:79022-3552
Practice Address - Country:US
Practice Address - Phone:806-249-8094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD.C.4307111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0013062-01Medicaid
TX601624Medicare ID - Type Unspecified
TXT16546Medicare UPIN