Organization
JOHN P GRAY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P GRAY MD (OWNER)
(936) 675-1065
Entity
Organization
Contact information
Practice address
1204 N MOUND ST, NACOGDOCHES, TX 75961-4027
(936) 462-7844
(936) 462-7855
Mailing address
4100 INTERNATIONAL PLAZA, SUITE 600, FORT WORTH, TX 76109-4823
(817) 334-0530
(817) 877-0350
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
K7025
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046NA
BC/BS
TX
05
—
180299301
—
TX
Enumeration date
10/24/2007
Last updated
08/28/2014
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