Healthcare Provider Details

I. General information

NPI: 1821910837
Provider Name (Legal Business Name): JESSECA D RAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 W SPRING CREEK PKWY STE 602
PLANO TX
75024-5306
US

IV. Provider business mailing address

4025 TYNES DR
GARLAND TX
75042-4637
US

V. Phone/Fax

Practice location:
  • Phone: 972-596-0035
  • Fax:
Mailing address:
  • Phone: 903-805-2290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: