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General NPI Number Information
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NPI Number | 1093529851
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Entity Type | Individual
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Provider Name | JOSIE MACKENZIE RAY
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 525 A H EHRIG DR
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City | BRENHAM
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State | TX
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Zip | 77833-2428
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Country | US
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Telephone | 979-277-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 232 HICKORY ST
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City | HUNTSVILLE
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State | TX
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Zip | 77320-3428
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Country | US
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Telephone | 832-656-1087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT10108
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000057568
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License Number State | TX
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