Provider Demographics
NPI:1568630192
Name:RAY, AMY M (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18333 EGRET BAY BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3239
Mailing Address - Country:US
Mailing Address - Phone:281-332-3001
Mailing Address - Fax:281-332-3005
Practice Address - Street 1:18333 EGRET BAY BLVD STE 140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3239
Practice Address - Country:US
Practice Address - Phone:281-332-3001
Practice Address - Fax:281-332-3005
Is Sole Proprietor?:No
Enumeration Date:2008-02-17
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0660207Q00000X, 207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8KK733OtherBCBSTX
TX8DK499OtherBCBS-TX
MS02135078Medicaid
TX8DK499OtherBCBS-TX
TX1568630192OtherTRICARE - SOUTH
TX1568630192OtherTRICARE - SOUTH
LA1-00031-1Medicaid