Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | Q0345 | TX |
N | 208000000X | Pediatrician | Q0345 | TX |
NPI | 1083960884 |
---|---|
Provider Name | Dr. Joseph William Ray |
First Address | Galveston, TX 77555-0359 |
Second Address | Galveston, TX 77555-0359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2012 |
Last Update Date | 07/04/2016 |