Provider Demographics
NPI:1639351216
Name:RAY, DUSTIN L (MD)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:L
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 1:9 MEDICAL PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7852
Mailing Address - Country:US
Mailing Address - Phone:888-544-3339
Mailing Address - Fax:214-853-5728
Practice Address - Street 1:9 MEDICAL PKWY STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7852
Practice Address - Country:US
Practice Address - Phone:888-544-3339
Practice Address - Fax:214-853-5728
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN66052086S0105X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand