Provider Demographics
NPI:1871889048
Name:BOCKOVER, RAY (ATP, CRTS)
Entity type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:BOCKOVER
Suffix:
Gender:M
Credentials:ATP, CRTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12012 COUNTY ROAD 283 E
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-6010
Mailing Address - Country:US
Mailing Address - Phone:903-509-4446
Mailing Address - Fax:
Practice Address - Street 1:13213 HWY 155 S
Practice Address - Street 2:SUITE B
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-6561
Practice Address - Country:US
Practice Address - Phone:903-509-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other