Provider Demographics
NPI:1770803850
Name:RAY, KARAH REENA (MS, RD, LD, CDE)
Entity type:Individual
Prefix:
First Name:KARAH
Middle Name:REENA
Last Name:RAY
Suffix:
Gender:F
Credentials:MS, RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 CENTER RIDGE DR APT 1115
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1284
Mailing Address - Country:US
Mailing Address - Phone:512-731-7153
Mailing Address - Fax:
Practice Address - Street 1:701 CENTER RIDGE DR APT 1115
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-1284
Practice Address - Country:US
Practice Address - Phone:512-731-7153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81110133V00000X
TX00994711133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered