Individual
MS. BEVERLY JEAN MACGRAY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.T
Contact information
Practice address
6015 BERKSHIRE LN, DALLAS, TX 75225-5705
(214) 696-3500
(214) 696-4090
Mailing address
6015 BERKSHIRE LN, DALLAS, TX 75225-5705
(214) 696-3500
(214) 696-4090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1-8387-1
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T2112
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/16/2006
Last updated
07/08/2007
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