Provider Demographics
NPI:1588159966
Name:AUDREY RALEY OD PLLC
Entity type:Organization
Organization Name:AUDREY RALEY OD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:RALEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:830-302-3357
Mailing Address - Street 1:2188 STATE HIGHWAY 46 W STE 102
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4467
Mailing Address - Country:US
Mailing Address - Phone:830-302-3357
Mailing Address - Fax:830-302-3358
Practice Address - Street 1:2188 W STATE HIGHWAY 46 STE 102
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4467
Practice Address - Country:US
Practice Address - Phone:210-844-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9198TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty