Individual
ELIA J GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4646 CORONA DR, CORPUS CHRISTI, TX 78411-4320
(361) 334-1609
(361) 906-0478
Mailing address
4646 CORONA DR, CORPUS CHRISTI, TX 78411-4320
(361) 334-1609
(361) 906-0478
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
604533
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477506038
HOME HEALTH PROVIDER
TX
Enumeration date
06/05/2020
Last updated
06/05/2020
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