Provider Demographics
NPI:1205211497
Name:GRAY, JAY PAUL (PA-C)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:PAUL
Last Name:GRAY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5310 HARVEST HILL RD
Mailing Address - Street 2:STE 290
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-5826
Mailing Address - Country:US
Mailing Address - Phone:214-420-0650
Mailing Address - Fax:214-736-0512
Practice Address - Street 1:5120 SW 28TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2321
Practice Address - Country:US
Practice Address - Phone:785-408-5800
Practice Address - Fax:785-730-8700
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2020-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS15-01824363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant