Individual provider Active NPI

Patrick J Ray, PH.D.

  • Psychologist
  • College Station, TX
National Provider Identifier
1457493868
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
23098 Issued in TX
Practice address
1700 University Dr E
College Station, TX 77840-2661
Phone
(979) 691-3300
Fax
(979) 691-3527
NPI assigned
Feb 13, 2007
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 23098 TX Primary

Addresses

Primary practice location

1700 University Dr E
College Station, TX 77840-2661

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other identifiers 3

IdentifierTypeStateIssuer
205228OtherMOMO BLUE SHIELD
498410901MedicaidMO
82815OtherARARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080114000336 TX Practitioner - Clinical Psychologist 0446243968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Texas Tech University Health Science Center School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1280 Arrington Rd
Suite 200
College Station, TX 77845-8696
Phone (979) 207-6550

1700 University Dr E
College Station, TX 77840-2661
Phone (979) 691-3300

1700 University Dr E Entrance 16
Care Clinic College Station University Dr
College Station, TX 77840-2661
Phone (979) 207-3636

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
23098TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Jan 2, 2008 Accepting new patients
Scott & White Clinic CurrentSince Jan 2, 2008 Accepting new patients

Locations

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

1700 University Dr E
College Station, TX 77840
Phone (979) 691-3300

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1457493868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY DR E",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402661",
            "telephone_number": "979-691-3300",
            "fax_number": "979-691-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "23098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BLUE SHIELD",
            "identifier": "205228",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498410901",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK BLUE SHIELD",
            "identifier": "82815",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.