Provider Demographics
NPI:1568708006
Name:RALEY, MARVIN RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:RAY
Last Name:RALEY
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 1:1221 WELCH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1180
Mailing Address - Country:US
Mailing Address - Phone:832-646-6867
Mailing Address - Fax:
Practice Address - Street 1:1221 WELCH ST APT 2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-1180
Practice Address - Country:US
Practice Address - Phone:832-646-6867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE46172080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine