MR. JACKIE RAY JR. (NPI# 1962866152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962866152 |
| Entity Type | Individual |
| Full Name | MR. JACKIE RAY JR. |
| Credential | LSA |
| Practice Address |
2007 Megan Ct Wylie TX 75098 |
| Mailing Address |
2007 Megan Ct Wylie TX 75098-6019 |
| Practice Telephone | 4696586589 |
| Mailing Telephone | 4696586589 |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2018-08-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
SA00672 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770090672 | Jackie D Ray | Counselor | 1 Mustard St Ste 2000, Rochester, NY 14609-6980 | 2018-01-02 |
| Street Address |
2007 MEGAN CT |
| City | WYLIE |
| State | TX |
| Zip Code | 75098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851926182 | Ashley Michelle Akers | Counselor | 303 Tx-78, #100, Wylie, TX 75098 | 2020-03-06 |
| 1033742762 | Neuro Care LLC | Psychiatry & Neurology | 801 S Tx- 78, Wylie, TX 75098 | 2020-02-21 |
| 1720623515 | Dentalhub of Wylie | Clinic/Center | 3483 W.fm 544, Unit- 112, Wylie, TX 75098 | 2019-11-15 |
| 1780144147 | Rxcare Pharmacy, LLC | Pharmacy | 209 N Ballard Ave, Wylie, TX 75098 | 2019-03-21 |
| 1659830081 | Bv Dental, Pllc | Clinic/Center | 330 S. State Highway 78, Suite 200, Wylie, TX 75098 | 2019-03-15 |
| 1407329352 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 8516 Parker Rd E., Wylie, TX 75098 | 2019-01-03 |
| 1396215620 | Lilian Abagwe | Nurse Practitioner | 1108 Ann Dr, Wylie, Wylie, TX 75098 | 2018-11-29 |
| 1114408507 | Stephen Clayton Heath | Occupational Therapy Assistant | 721 Tx-78, Wylie, TX 75098 | 2018-08-24 |
| 1831677400 | Melody Lea Stoker | Physical Therapy Assistant | 3400 Mcmillen Rd Apt 1028, Wylie, TX 75098 | 2018-08-05 |
| 1619465234 | Olufemi Fadahunsi, Dds, PC | Dentist | 2810 W. Fm544, Suite 100, Wylie, TX 75098 | 2018-04-30 |
| Find all providers in zip 75098 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215485081 | Kohler First Assistants, Inc. | Physician Assistant | 226 Lake Texoma Dr, Wylie, TX 75098-4872 | 2016-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133340 | Mark Alan Williams | Physician Assistant | 4814 Lake Livingston Dr, Corpus Christi, TX 78413-5139 | 2020-10-28 |
| 1669081238 | Manuel V Leyva | Physician Assistant | 8407 Sunset Loch Dr, Spring, TX 77379-5121 | 2020-07-29 |
| 1194342212 | Sean Robert Jamieson | Physician Assistant | 2700 E Broad St Ste 200, Mansfield, TX 76063-5899 | 2020-07-06 |
| 1588284194 | Hill Country Surgical Management, Inc | Physician Assistant | 10454 Tippecanoe, San Antonio, TX 78245-3128 | 2020-04-23 |
| 1407475585 | Serenity Surgical Services | Physician Assistant | 3260 Springbok Cir, Frisco, TX 75034-3671 | 2020-04-09 |
| 1720610470 | Surgical Assistants of South Texas | Physician Assistant | 3414 Highway 146 S, La Porte, TX 77571-7400 | 2020-02-11 |
| 1710524103 | R & H Surgical Services, LLC | Physician Assistant | 14507 Parkesgate Dr, Houston, TX 77083-5792 | 2019-12-04 |
| 1639711195 | Landry & Kiejna Surgical Assisting | Physician Assistant | 1120 Business Center Dr Ste 110, Houston, TX 77043-2735 | 2019-10-16 |
| 1912558693 | Chandrant Akshar Pa | Physician Assistant | 400 W Arbrook Blvd Ste 230, Arlington, TX 76014-3174 | 2019-09-24 |
| 1700435831 | Christina A Vogel-rosbrook | Physician Assistant | 4330 Medical Drive, Suite 120, San Antonio, TX 78229-3353 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.