MR. Jackie Ray JR., LSA

NPI #1962866152 in Wylie, Texas

Provider Information

NPI Number
1962866152
Entity Type
Individual
Name
MR. Jackie Ray JR., LSA
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant - Surgical
Credential
LSA
Enumeration Date
Apr 13, 2016
Last Updated
Aug 2, 2018

Practice Location

Address
2007 MEGAN CT
City
Wylie
State
Texas
ZIP Code
75098
Phone
(469) 658-6589

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist, Other - Surgical AssistantSurgical Assistant
Physician Assistant - SurgicalSurgical

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