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General NPI Number Information
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NPI Number | 1417081142
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Entity Type | Organization
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Legal Business Name | DAVID A RAY D O P A
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 808 WOODROW WILSON RAY CIR
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City | BRIDGEPORT
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State | TX
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Zip | 76426-2061
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Country | US
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Telephone | 940-683-2297
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Fax | 940-683-2984
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Provider Business Mailing Address
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Address Line | 808 WOODROW WILSON RAY CIR
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City | BRIDGEPORT
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State | TX
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Zip | 76426-2061
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Country | US
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Telephone | 940-683-2297
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Fax | 940-683-2984
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Authorized Official
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Title or Position | DOCTOR
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Name | DAVID A RAY
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Credential | D. O.
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Telephone | 940-683-2297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E2807
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License Number State | TX
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