Provider Demographics
NPI:1104212661
Name:RAY, COBY NIELSON (MD, MS, MBA)
Entity Type:Individual
Prefix:DR
First Name:COBY
Middle Name:NIELSON
Last Name:RAY
Suffix:
Gender:M
Credentials:MD, MS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8905 JUNEAU AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-7847
Mailing Address - Country:US
Mailing Address - Phone:469-387-9921
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST # MS 7217
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-11
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2478207W00000X
TXBP10063333207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology