1902945355 NPI number — MRS. CARRI HODGE RAY M.S.

Table of content: MRS. CARRI HODGE RAY M.S. (NPI 1902945355)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902945355 NPI number — MRS. CARRI HODGE RAY M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAY
Provider First Name:
CARRI
Provider Middle Name:
HODGE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HODGE
Provider Other First Name:
CARRI
Provider Other Middle Name:
LEEANNE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902945355
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 FM 2181
Provider Second Line Business Mailing Address:
#300
Provider Business Mailing Address City Name:
HICKORY CREEK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75065-7636
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-321-1311
Provider Business Mailing Address Fax Number:
940-497-1374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2122 RUFE SNOW DR
Provider Second Line Business Practice Location Address:
#114
Provider Business Practice Location Address City Name:
KELLER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76248-5691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-321-1311
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  80217 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237700000X , with the licence number: 80217 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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