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General NPI Number Information
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NPI Number | 1063069235
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Entity Type | Individual
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Provider Name | GRAYSON H GILLETTE DPT
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Gender | Male
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1830 S MILLBEND DR
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1411
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Country | US
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Telephone | 281-789-3012
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Fax |
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Provider Business Mailing Address
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Address Line | 2017 LOU ELLEN LN UNIT A
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City | HOUSTON
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State | TX
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Zip | 77018-6154
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Country | US
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Telephone | 918-398-3228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1320782
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License Number State | TX
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