Individual provider · NPI-1

Jacob Michael Bray, OD

Optometrist · Longview, TX

NPI number1730860651
StatusActive
Last updated in NPPESJul 25, 2023

Details

NPI
1730860651
Entity type
Individual (NPI-1)
Name
Jacob Michael Bray
Credential
OD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 25, 2023
Certification date
Jul 25, 2023
Last updated
Jul 25, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist10895TTXYes

Practice location

1821 Judson Rd
Longview, TX 75605-4710

Phone 903-758-8832 · Fax 903-238-8876

Mailing address

1821 Judson Rd
Longview, TX 75605-4710

Phone 903-758-8832 · Fax 903-238-8876

Other practice locations

2306 E End Blvd S
Marshall, TX 75672-7469

Phone 903-938-2555 · Fax 903-938-1011

105 Cottage Rd
Carthage, TX 75633-1507

Phone 903-693-7745 · Fax 903-693-8971

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