Provider Demographics
NPI:1497736482
Name:FITZGERALD, RAY M (MD)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:M
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4356
Mailing Address - Street 2:DEPT 665
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4356
Mailing Address - Country:US
Mailing Address - Phone:281-440-6960
Mailing Address - Fax:281-440-6205
Practice Address - Street 1:17270 RED OAK DR
Practice Address - Street 2:STE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2632
Practice Address - Country:US
Practice Address - Phone:281-440-6960
Practice Address - Fax:281-440-6205
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD8212207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMO025817OtherDPS
TX125727104Medicaid
TXD8212OtherTEXAS LICENSE
TXD8212OtherTEXAS LICENSE
TXD8212OtherTEXAS LICENSE
TXMO025817OtherDPS