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NPI 1750373775

NPI 1750373775 : LOU ANN GRAY DDS : MIDLAND, TX

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General NPI Number Information
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    NPI Number           |    1750373775
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    Entity Type          |    Individual 
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    Provider Name        |    LOU ANN GRAY DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/16/2005
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3000 N GARFIELD ST SUITE 220
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    City                 |    MIDLAND
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    State                |    TX
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    Zip                  |    79705-6400
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    Country              |    US
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    Telephone            |    432-683-5313
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3000 N GARFIELD ST SUITE 220
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    City                 |    MIDLAND
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    State                |    TX
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    Zip                  |    79705-6400
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    Country              |    US
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    Telephone            |    432-683-5313
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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        |    1223P0700X
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    Taxonomy Name        |    Prosthodontics
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    License Number       |    12,570
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    License Number State |    TX
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