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NPI Code Detail

MEDICARE: MRS. BEULAH M GRAY RN

MEDICARE:  MRS. BEULAH M GRAY  RN
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
1163WC0400XCase Management Registered Nurse533409TX

General Provider Information

NPI Number : 1790836260
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BEULAH M GRAY RN
Provider Business Mailing Address
First Line : 7426 MACZALI DR
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77489-3319
Country : US
Telephone Number : 281-216-7375
Fax Number : 281-437-8224
Provider Business Practice Location Address
First Line : 7426 MACZALI DR
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77489-3319
Country : US
Telephone Number : 281-216-7375
Fax Number : 281-437-8224
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 07/08/2007

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