Organization
RANDELL R RAY PC
Active
Parent organization
RANDELL R RAY PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RANDELL R RAY PC
Authorized official
RANDELL R RAY O.D. (PRESIDENT)
(817) 526-5558
Entity
Organization
Contact information
Practice address
1616 W HENDERSON ST, CLEBURNE, TX 76033-4123
(817) 526-5558
(817) 526-5825
Mailing address
1420 AIRPORT FWY STE H, BEDFORD, TX 76022-6778
(817) 283-2001
(817) 283-0993
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2873TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014FG
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
09/22/2009
Last updated
05/08/2020
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