Provider Demographics
NPI:1790577591
Name:HANSBERGER, RAY BROWN (RN)
Entity type:Individual
Prefix:MR
First Name:RAY
Middle Name:BROWN
Last Name:HANSBERGER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5619 W LOOP 1604 N STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5795
Mailing Address - Country:US
Mailing Address - Phone:210-888-1358
Mailing Address - Fax:
Practice Address - Street 1:5619 W LOOP 1604 N STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-5795
Practice Address - Country:US
Practice Address - Phone:210-888-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1134590163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse