Provider Demographics
NPI:1033742754
Name:GRAY, THOMAS ALAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALAN
Last Name:GRAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 PARK BEND DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-8164
Mailing Address - Country:US
Mailing Address - Phone:832-414-3914
Mailing Address - Fax:
Practice Address - Street 1:6315 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9686
Practice Address - Country:US
Practice Address - Phone:346-216-4155
Practice Address - Fax:346-216-4157
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0204451835P0018X
TX400451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist