Randell R Ray Pc | |
1616 W Henderson St Cleburne TX 76033-4123 | |
(817) 526-5558 | |
(817) 526-5825 |
Full Name | Randell R Ray Pc |
---|---|
Speciality | Clinic/Center |
Location | 1616 W Henderson St, Cleburne, Texas |
Authorized Official Name and Position | Randell R Ray (PRESIDENT) |
Authorized Official Contact | 8175265558 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Randell R Ray Pc 1420 Airport Fwy Ste H Bedford TX 76022-6778 Ph: (817) 283-2001 | Randell R Ray Pc 1616 W Henderson St Cleburne TX 76033-4123 Ph: (817) 526-5558 |
NPI Number | 1972837094 |
---|---|
Provider Enumeration Date | 09/22/2009 |
Last Update Date | 05/08/2020 |
Medicare PECOS PAC ID | 3870632177 |
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Medicare Enrollment ID | O20091130000145 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972837094 | NPI | - | NPPES |
0014FG | Other | TX | BLUE CROSS BLUE SHIELD OF TEXAS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 2873TG (Texas) | Primary |
Provider Name | Randell R Ray |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1780622357 PECOS PAC ID: 5890834196 Enrollment ID: I20091130000121 |
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