Provider Demographics
NPI:1053740951
Name:CHERNLY, RAY (DAOM, LAC)
Entity type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:CHERNLY
Suffix:
Gender:M
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 W HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2939
Mailing Address - Country:US
Mailing Address - Phone:817-498-8449
Mailing Address - Fax:817-281-4829
Practice Address - Street 1:470 W HARWOOD RD
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054
Practice Address - Country:US
Practice Address - Phone:817-498-8449
Practice Address - Fax:817-281-4829
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01483171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12615429OtherCAQH
TX3060641OtherCIGNA
TX5493899OtherAETNA
TX12615429OtherCAQH