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NPI Code Detail

MEDICARE: BEYOND THE GRAY SKY LLC

MEDICARE: BEYOND THE GRAY SKY LLC
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1780976076
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEYOND THE GRAY SKY LLC
Provider Business Mailing Address
First Line : 1700 COVEMEADOW DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76012-5407
Country : US
Telephone Number : 972-836-9387
Fax Number :
Provider Business Practice Location Address
First Line : 1700 COVEMEADOW DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76012-5407
Country : US
Telephone Number : 972-836-9387
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ANDRES DIOSDADO
Credential :
Telephone Number : 940-594-5418
Provider Enumeration Date : 05/05/2011
Last Update Date : 09/11/2025

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Directions to “BEYOND THE GRAY SKY LLC ” Practice Location

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