Individual
RAY A ROUGEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12704 BRUCE DR, BALCH SPRINGS, TX 75180-5301
(469) 774-7483
Mailing address
12704 BRUCE DR, BALCH SPRINGS, TX 75180-5301
(469) 774-7483
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
13045227
TX
343800000X
Secured Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE
—
TX
Enumeration date
08/29/2022
Last updated
04/09/2024
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