Provider Demographics
NPI:1245501238
Name:RAY, NATALIE R (CRNA)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:R
Last Name:RAY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:R
Other - Last Name:PRITCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5944 LUTHER LN STE 915
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5977
Mailing Address - Country:US
Mailing Address - Phone:803-665-4539
Mailing Address - Fax:
Practice Address - Street 1:5944 LUTHER LN STE 915
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5977
Practice Address - Country:US
Practice Address - Phone:803-665-4539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC81219163W00000X
TX089903367500000X
TXAP121866367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8709UGOtherBCBS
TXP01358056OtherRR
TX298747101Medicaid
TX298747102Medicaid
TX8709UGOtherBCBS
TX298747103Medicaid
TXTXB154404Medicare PIN