Provider Demographics
NPI:1063453512
Name:MCCRAY, JOHN GREGORY (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GREGORY
Last Name:MCCRAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 MCMAKIN RD
Mailing Address - Street 2:
Mailing Address - City:BARTONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-8438
Mailing Address - Country:US
Mailing Address - Phone:940-455-7100
Mailing Address - Fax:940-455-7105
Practice Address - Street 1:80 MCMAKIN RD
Practice Address - Street 2:
Practice Address - City:BARTONVILLE
Practice Address - State:TX
Practice Address - Zip Code:76226-8438
Practice Address - Country:US
Practice Address - Phone:940-455-7100
Practice Address - Fax:940-455-7105
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184369001Medicaid
TXL9806OtherMEDICAL LICENSE
TX349779YKP5Medicare PIN
I69908Medicare UPIN
TX8F4490Medicare PIN