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MR. JACKIE RAY JR. LSA
NPI 1962866152
Physician Assistant - Surgical in Wylie, TX

Active since April 13, 2016
2007 MEGAN CT, WYLIE, TX 75098(469) 658-6589 Get Directions Write a Review

NPPES record last updated: August 2, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Jackie Ray Jr. Lsa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACKIE RAY JR. LSA (NPI 1962866152) is an individual surgical provider in Wylie, Texas, licensed in Texas (SA00672) and active in the NPI registry since April 2016.

NPPES Registry Identity

NPI1962866152
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameMR. JACKIE RAY JR.Credential: LSA
Location Address2007 MEGAN CTWylie, TX 75098
Mailing Address2007 Megan CtWylie, TX 75098-6019 · (469) 658-6589
Phone(469) 658-6589
Sole ProprietorYes
Enumeration DateApril 13, 2016
Last NPPES UpdateAugust 2, 2018
✔ NPI 1962866152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in TX · SA00672
Also ListedSpecialist/Technologist, Other · Surgical AssistantTaxonomy 246ZC0007X
2007 MEGAN CT, Wylie, TX 75098
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackie Ray's NPI number?

The NPI number for Jackie Ray is 1962866152. It was assigned to this individual provider in the NPPES registry on April 13, 2016.

Where is Jackie Ray located?

Jackie Ray practices at 2007 Megan Ct, Wylie, TX 75098. The listed phone number is (469) 658-6589.

What is Jackie Ray's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Jackie Ray was last updated on August 2, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.