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NPI Code Detail

MEDICARE: DR. JOHN A WRAY D.O.

MEDICARE: DR. JOHN A WRAY D.O.
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
1207Q00000XFamily Medicine PhysicianF7330TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2127308100OTHERTXFIRST CARE
384Z210OTHERBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1700882230
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN A WRAY D.O.
Provider Business Mailing Address
First Line : 6417 CENTRAL PARK BLVD
Second Line :
City : ABILENE
State : TX
Zip : 79606-5884
Country : US
Telephone Number : 325-695-6370
Fax Number : 325-692-6595
Provider Business Practice Location Address
First Line : 6417 CENTRAL PARK BLVD
Second Line :
City : ABILENE
State : TX
Zip : 79606-5884
Country : US
Telephone Number : 325-695-6370
Fax Number : 325-692-6595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 03/30/2019

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