Provider Demographics
NPI:1093529851
Name:RAY, JOSIE MACKENZIE
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:MACKENZIE
Last Name:RAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77320-3428
Mailing Address - Country:US
Mailing Address - Phone:832-656-1087
Mailing Address - Fax:
Practice Address - Street 1:525 A H EHRIG DR
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-2428
Practice Address - Country:US
Practice Address - Phone:979-277-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT101082255A2300X
TX20000575682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer