Provider Demographics
NPI:1164771226
Name:WILRAY LLC
Entity Type:Organization
Organization Name:WILRAY LLC
Other - Org Name:RX AT HWY 6
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:TORAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:281-403-1121
Mailing Address - Street 1:5201 HIGHWAY 6 SOUTH
Mailing Address - Street 2:STE 200
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459
Mailing Address - Country:US
Mailing Address - Phone:281-403-1121
Mailing Address - Fax:281-403-1112
Practice Address - Street 1:5201 HIGHWAY 6 SOUTH
Practice Address - Street 2:STE 200
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459
Practice Address - Country:US
Practice Address - Phone:281-403-1121
Practice Address - Fax:281-403-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty