Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD035869 | DC |
N | 208600000X | Surgeon | MD035869 | DC |
Y | 2086S0105X | Surgery of the Hand | N6605 | TX |
NPI | 1639351216 |
---|---|
Provider Name | Dustin L. Ray |
First Address | Plano, TX 75024-7144 |
Second Address | Southlake, TX 76092-6382 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2007 |
Last Update Date | 22/03/2018 |