Individual
GRAYSON THOMAS FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(504) 920-4729
Mailing address
3421 HAMILTON AVE, FORT WORTH, TX 76107-1852
(504) 920-4729
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
799542
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP140482
TX
Other
Enumeration date
11/01/2018
Last updated
03/19/2020
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