Individual
DR. PAUL EDWARD GRAY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 PENNSYLVANIA AVE., SUITE 720, FORT WORTH, TX 76104-2144
(817) 332-2998
(817) 336-8941
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 378-3699
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M6639
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189954404
—
TX
01
—
P01782072
RAILROAD MEDICARE
—
Enumeration date
05/21/2007
Last updated
10/13/2020
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