Individual
GARY WENDELL RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
2505 S CARRIER PKWY, GRAND PRAIRIE, TX 75052-5017
(972) 264-0268
(972) 262-1750
Mailing address
2505 S CARRIER PKWY, GRAND PRAIRIE, TX 75052-5017
(972) 264-0268
(972) 262-1750
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141836
—
TX
Enumeration date
06/12/2008
Last updated
11/07/2019
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