Provider Demographics
NPI:1346333739
Name:GRAY, BILLY ALVIN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:ALVIN
Last Name:GRAY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 MONTE CRISTO DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-3194
Mailing Address - Country:US
Mailing Address - Phone:903-892-0593
Mailing Address - Fax:903-868-2489
Practice Address - Street 1:2112 MONTE CRISTO DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3194
Practice Address - Country:US
Practice Address - Phone:903-892-0593
Practice Address - Fax:903-868-2489
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice