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General NPI Number Information
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NPI Number | 1780784256
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Entity Type | Individual
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Provider Name | CAROL COLEMAN GRAY M. D.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 3600 GASTON AVENUE WADLEY TOWER, SUITE 760
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City | DALLAS
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State | TX
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Zip | 75246
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Country | US
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Telephone | 214-826-6110
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Fax | 214-828-9127
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Provider Business Mailing Address
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Address Line | 3600 GASTON AVENUE WADLEY TOWER, SUITE 760
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City | DALLAS
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State | TX
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Zip | 75246
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Country | US
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Telephone | 214-826-6110
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Fax | 214-828-9127
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | D9463
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License Number State | TX
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