Provider Demographics
NPI:1255377826
Name:HYDE, RAY H IX (DDS)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:H
Last Name:HYDE
Suffix:IX
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4245 KEMP BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308
Mailing Address - Country:US
Mailing Address - Phone:940-692-5112
Mailing Address - Fax:940-692-5342
Practice Address - Street 1:4245 KEMP BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2824
Practice Address - Country:US
Practice Address - Phone:940-692-5112
Practice Address - Fax:940-692-5342
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX125781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice