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Individual

BILLY T GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3201 UNIVERSITY DR E, SUITE 135, BRYAN, TX 77802-3475
(979) 774-7587
(979) 774-0388
Mailing address
1802 SPRINGBROOK ESTATES DR, COLLEGE STATION, TX 77845-4788
(979) 777-0386
(979) 774-0388

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01414
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
TX
Enumeration date
10/14/2011
Last updated
06/20/2017
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