MEDICARE: YVONNE RAY

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	251E00000X	Home Health Agency	743026515	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699153221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE RAY

Provider Business Mailing Address
First Line	:	1015 GALLOWAY AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-1203
Country	:	US
Telephone Number	:	210-382-0010
Fax Number	:	214-758-0247

Provider Business Practice Location Address
First Line	:	1015 GALLOWAY AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-1203
Country	:	US
Telephone Number	:	210-382-0010
Fax Number	:	214-758-0247

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

Provider Enumeration Date	:	05/14/2015
Last Update Date	:	05/14/2015

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Directions to “ YVONNE RAY ” Practice Location

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