MEDICARE: TRISZA L RAY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4143	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356331052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRISZA L RAY DO

Provider Business Mailing Address
First Line	:	7422 E 67TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-1815
Country	:	US
Telephone Number	:	918-814-6417
Fax Number	:

Provider Business Practice Location Address
First Line	:	7422 E 67TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-1815
Country	:	US
Telephone Number	:	918-814-6417
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	10/15/2025

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Directions to “ TRISZA L RAY DO” Practice Location

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