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NPI Code Detail

MEDICARE: DR. KENT DWAYNE GRAY DC

MEDICARE: DR. KENT DWAYNE GRAY DC
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
1111N00000XChiropractor5964TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1043803190OTHERTXTAX IDENTIFICATION #

General Provider Information

NPI Number : 1467441840
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENT DWAYNE GRAY DC
Provider Business Mailing Address
First Line : PO BOX 1127
Second Line :
City : BORGER
State : TX
Zip : 79008-1127
Country : US
Telephone Number : 806-273-3366
Fax Number : 806-273-2532
Provider Business Practice Location Address
First Line : 5912 SPENCER HWY
Second Line :
City : PASADENA
State : TX
Zip : 77505-1602
Country : US
Telephone Number : 281-487-1501
Fax Number : 280-998-0558
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 05/10/2021

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Directions to “ DR. KENT DWAYNE GRAY DC” Practice Location

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