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NPI Code Detail

MEDICARE: DR. GINA ANNE GRAY MD

MEDICARE: DR. GINA ANNE GRAY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery PhysicianK0788TX

General Provider Information

NPI Number : 1538150065
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GINA ANNE GRAY MD
Provider Business Mailing Address
First Line : PO BOX 734812
Second Line :
City : DALLAS
State : TX
Zip : 75373-4812
Country : US
Telephone Number : 210-358-9183
Fax Number : 210-358-9183
Provider Business Practice Location Address
First Line : 701 S ZARZAMORA ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78207-5209
Country : US
Telephone Number : 210-358-7474
Fax Number : 210-358-7406
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 01/28/2021

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