Provider Demographics
NPI:1497809065
Name:SEXTON, RAY LESTER III (OD)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:LESTER
Last Name:SEXTON
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 N MAYS ST
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-2915
Mailing Address - Country:US
Mailing Address - Phone:512-255-2660
Mailing Address - Fax:512-255-2434
Practice Address - Street 1:1734 N MAYS ST
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2915
Practice Address - Country:US
Practice Address - Phone:512-255-2660
Practice Address - Fax:512-255-2434
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX02260T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E10KMedicaid
T15844Medicare UPIN
TX00E10KMedicare ID - Type Unspecified