Individual
LAWRENCE CHARLES GRAY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-8666
(210) 916-8712
Mailing address
1028 CYPRESS POINTE DR, CASEYVILLE, IL 62232-2830
(618) 531-6222
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101275124
VA
208D00000X
General Practice Physician
0101275124
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2020
Last updated
05/16/2024
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