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 1:232 HICKORY ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77320-3428
Practice Address - Country:US
Practice Address - Phone:832-656-1087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program