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Individual

LESLIE ANN GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPO

Contact information

Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 645-8250
(214) 645-8251
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-8250
(214) 645-8251

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
1136
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0443270001
RAILROAD MEDICARE
05
086893706
TX
Enumeration date
03/28/2006
Last updated
07/30/2008
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