Individual
DR. MARK B GRAY
Active
Individual
DR. MARK B GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
G6520
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139655808
CSHCN2
TX
05
—
139655809
—
TX
01
—
139655815
CSHCN1
TX
05
—
139655816
—
TX
01
—
300058890
RRMCARE
—
01
—
300127009
RRMCARE2
—
Enumeration date
06/09/2005
Last updated
01/12/2015
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