Provider Demographics
NPI:1306868716
Name:GRAYS, PETER EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:EDWARD
Last Name:GRAYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 CENTRAL DR
Mailing Address - Street 2:STE. 202
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-5831
Mailing Address - Country:US
Mailing Address - Phone:817-571-4620
Mailing Address - Fax:817-571-4701
Practice Address - Street 1:1909 CENTRAL DR
Practice Address - Street 2:STE. 202
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5831
Practice Address - Country:US
Practice Address - Phone:817-571-4620
Practice Address - Fax:817-571-4701
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6254208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00413662Medicare PIN
TX8J6386Medicare PIN
TXD86620Medicare UPIN
TX8J6387Medicare PIN
TX8J8226Medicare PIN
8F3605Medicare PIN
TXDG0778Medicare PIN
TX8J6388Medicare PIN