Individual
CHARLES GRAVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
11910 GREENVILLE AVE, SUITE 500, DALLAS, TX 75243-3596
(214) 572-1124
(214) 572-7724
Mailing address
11910 GREENVILLE AVE, SUITE 500, DALLAS, TX 75243-3596
(214) 572-1124
(214) 572-7724
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02247
TX
Other
Enumeration date
02/12/2008
Last updated
02/15/2012
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