Provider Demographics
NPI:1215812649
Name:RAY, LEONARD HEATH
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:HEATH
Last Name:RAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 SH 43
Mailing Address - Street 2:
Mailing Address - City:TATUM
Mailing Address - State:TX
Mailing Address - Zip Code:75691
Mailing Address - Country:US
Mailing Address - Phone:903-806-9134
Mailing Address - Fax:
Practice Address - Street 1:930 W JOHNSON ST
Practice Address - Street 2:
Practice Address - City:TATUM
Practice Address - State:TX
Practice Address - Zip Code:75691-9689
Practice Address - Country:US
Practice Address - Phone:903-806-9134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171W00000X
TX1002273332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No171W00000XOther Service ProvidersContractor