MEDICARE: PRISCILLA RAY MD

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	2084P0800X	Psychiatry Physician	E2808	TX

General Provider Information

NPI Number	:	1801897863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA RAY MD

Provider Business Mailing Address
First Line	:	6624 FANNIN ST
Second Line	:	STE 2120
City	:	HOUSTON
State	:	TX
Zip	:	77030-2312
Country	:	US
Telephone Number	:	713-797-0112
Fax Number	:	713-790-9578

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST
Second Line	:	STE 2120
City	:	HOUSTON
State	:	TX
Zip	:	77030-2312
Country	:	US
Telephone Number	:	713-797-0112
Fax Number	:	713-790-9578

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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