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General NPI Number Information
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NPI Number | 1427267145
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Entity Type | Individual
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Provider Name | PAUL EDWARD GRAY JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 1325 PENNSYLVANIA AVE., SUITE 720
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City | FORT WORTH
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State | TX
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Zip | 76104-2144
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Country | US
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Telephone | 817-332-2998
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Fax | 817-336-8941
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Provider Business Mailing Address
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Address Line | P.O. BOX 961205
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City | FORT WORTH
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State | TX
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Zip | 76161-1205
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Country | US
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Telephone | 817-740-8400
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Fax | 817-378-3699
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | M6639
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License Number State | TX
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