Provider Demographics
NPI:1912451006
Name:RAY, RAMON (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:RAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 LOS REYES ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-5806
Mailing Address - Country:US
Mailing Address - Phone:210-602-3554
Mailing Address - Fax:
Practice Address - Street 1:7910 TEAK LN
Practice Address - Street 2:#107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1763
Practice Address - Country:US
Practice Address - Phone:210-819-5243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-07
Last Update Date:2016-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice