Provider Demographics
NPI:1316616691
Name:DYAR, DILLON RAY
Entity type:Individual
Prefix:
First Name:DILLON
Middle Name:RAY
Last Name:DYAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 MICHIGAN CT
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79607-1000
Mailing Address - Country:US
Mailing Address - Phone:864-276-1121
Mailing Address - Fax:
Practice Address - Street 1:PSC 2 BOX 327
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96264-0004
Practice Address - Country:US
Practice Address - Phone:325-782-4224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians