Provider Demographics
NPI:1437175411
Name:RAY, ROBERT BRADLEY (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BRADLEY
Last Name:RAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 GRUENE PARK DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2459
Mailing Address - Country:US
Mailing Address - Phone:830-625-5252
Mailing Address - Fax:830-625-0225
Practice Address - Street 1:55 GRUENE PARK DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2459
Practice Address - Country:US
Practice Address - Phone:830-625-5252
Practice Address - Fax:830-625-0225
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4667207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5826310001OtherCIGNA GOVERNMENT SERVICE
TX8V5010OtherBLUE CROSS BLUE SHIELD
I02488Medicare UPIN
TX8F3623Medicare PIN