Provider Demographics
NPI:1942973086
Name:RAY, BRISA CONTRERAS (PA)
Entity Type:Individual
Prefix:
First Name:BRISA
Middle Name:CONTRERAS
Last Name:RAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6767 LAKE WOODLANDS DR STE F
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2566
Mailing Address - Country:US
Mailing Address - Phone:832-698-0111
Mailing Address - Fax:832-698-0153
Practice Address - Street 1:20639 KUYKENDAHL RD STE 200
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3587
Practice Address - Country:US
Practice Address - Phone:832-698-0111
Practice Address - Fax:832-698-0153
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
TXPA16164363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program