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NPI Code Detail

MEDICARE: MS. TOTUNDRA GRAYS PHD, LCSW, MPA

MEDICARE: MS. TOTUNDRA GRAYS PHD, LCSW, MPA
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
11041C0700XClinical Social Worker35577TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629329388
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TOTUNDRA GRAYS PHD, LCSW, MPA
Provider Business Mailing Address
First Line : PO BOX 411338
Second Line :
City : DALLAS
State : TX
Zip : 75241-8338
Country : US
Telephone Number : 214-697-4269
Fax Number :
Provider Business Practice Location Address
First Line : 15800 SEAGOVILLE RD
Second Line :
City : DALLAS
State : TX
Zip : 75253-5703
Country : US
Telephone Number : 972-892-7180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2012
Last Update Date : 07/21/2022

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