Provider Demographics
NPI:1992132518
Name:NOLEN, JOHN RAY JR (ORT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RAY
Last Name:NOLEN
Suffix:JR
Gender:M
Credentials:ORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 STEWART DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6573
Mailing Address - Country:US
Mailing Address - Phone:214-886-8759
Mailing Address - Fax:
Practice Address - Street 1:1438 STEWART DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6573
Practice Address - Country:US
Practice Address - Phone:214-886-8759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist