Ray, Gary Wendell

Ray, Gary Wendell is an sole proprietor health care provider with primary practice located at 2505 S Carrier Pkwy , Grand Prairie TX 75052-5017. He recently has only one registered license in Suppliers / Compounding Pharmacy, which is considered as his primary health care specialty. Ray, Gary Wendell can be contacted via phone (972) 264-0268.

Contact Information

Primary practice address
2505 S Carrier Pkwy Grand Prairie TX 75052-5017
Fax: (972) 262-1750
Website:

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1497915433
LBN Legal business name Ray, Gary Wendell
Credentials R. PH.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 12th, 2008
Last updated Nov 7th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497915433 NPPES
Texas MEDICAID 141836

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