Provider Demographics
NPI:1457472714
Name:RAY, CHRISTEL H (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTEL
Middle Name:H
Last Name:RAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTEL
Other - Middle Name:H
Other - Last Name:JOHNSON-RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, OCS, FAAOMPT
Mailing Address - Street 1:411 N WASHINGTON AVE
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1713
Mailing Address - Country:US
Mailing Address - Phone:214-820-7457
Mailing Address - Fax:717-635-4921
Practice Address - Street 1:3107 W CAMP WISDOM RD
Practice Address - Street 2:#131
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2643
Practice Address - Country:US
Practice Address - Phone:214-339-4533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1167680225100000X
MO114893225100000X
KS11-03019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist