MEDICARE: MRS. LISA ANN RAY WHCNP RNC

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	363LW0102X	Women's Health Nurse Practitioner	589784	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	148384401	OTHER	TX	TPI

General Provider Information

NPI Number	:	1447313382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA ANN RAY WHCNP RNC

Provider Business Mailing Address
First Line	:	7424 GREENVILLE AVE
Second Line	:	SUITE 206
City	:	DALLAS
State	:	TX
Zip	:	75231-4534
Country	:	US
Telephone Number	:	214-363-2004
Fax Number	:	214-696-2091

Provider Business Practice Location Address
First Line	:	600 N CENTRAL EXPY STE 601
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-6938
Country	:	US
Telephone Number	:	972-424-6311
Fax Number	:	972-423-7659

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	04/17/2026

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