MEDICARE: MEGHAN GRAY

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
1	363LF0000X	Family Nurse Practitioner	1228869	TX

General Provider Information

NPI Number	:	1790649549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN GRAY

Provider Business Mailing Address
First Line	:	1400 S COULTER ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-1786
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 S COULTER ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-1786
Country	:	US
Telephone Number	:	806-414-9559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	03/11/2026

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