Provider Demographics
NPI:1952667149
Name:RAY W NG DPM PA
Entity Type:Organization
Organization Name:RAY W NG DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:NG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:972-396-7888
Mailing Address - Street 1:1105 CENTRAL EXPRESWAY NORTH
Mailing Address - Street 2:MOB II STE 2300
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6119
Mailing Address - Country:US
Mailing Address - Phone:972-396-7888
Mailing Address - Fax:972-563-2294
Practice Address - Street 1:1105 CENTRAL EXPRESWAY NORTH
Practice Address - Street 2:MOB II STE 2300
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6119
Practice Address - Country:US
Practice Address - Phone:972-396-7888
Practice Address - Fax:972-563-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty