Provider Demographics
NPI:1760505010
Name:RAY, JEFFREY H (O D)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:H
Last Name:RAY
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 EXPRESS ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-6706
Mailing Address - Country:US
Mailing Address - Phone:214-741-6660
Mailing Address - Fax:214-741-6676
Practice Address - Street 1:130 EXPRESS ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-6706
Practice Address - Country:US
Practice Address - Phone:214-741-6660
Practice Address - Fax:214-741-6676
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3523T152W00000X
TX3523TG152WC0802X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy