Individual provider · Type 1 NPI
Jackie Ray Jr., LSA
Surgical Physician Assistant · Wylie, TX
NPI number
1962866152
Active
Practice location
2007 Megan Ct
Wylie, TX 75098
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Assistant | 246ZC0007X | None listed |
| Surgical Physician Assistant Primary | 363AS0400X | SA00672 (TX) |
Surgical Physician Assistant: Definition to come...
About NPI 1962866152
Jackie Ray Jr., LSA's National Provider Identifier is 1962866152, issued on Apr 13, 2016. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Wylie, TX. The record was last updated on Aug 2, 2018.