Provider Demographics
NPI:1710067145
Name:BRAY, JAMES (PHD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BRAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4349 MARTIN LUTHER KING BLVD STE 1001E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77204-3074
Mailing Address - Country:US
Mailing Address - Phone:713-743-9682
Mailing Address - Fax:713-743-1049
Practice Address - Street 1:4349 MARTIN LUTHER KING BLVD HEALTH 2 BLDG STE 1001E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77204-3900
Practice Address - Country:US
Practice Address - Phone:713-743-9682
Practice Address - Fax:713-743-1049
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-2293103T00000X
TX1779106H00000X
TX22293103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029909102Medicaid
TX8C7709Medicare PIN
TX0025BTMedicare PIN