Provider Demographics
NPI:1346401940
Name:GRAYSON, STEPHEN ERIC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ERIC
Last Name:GRAYSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E JACKSON ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-6888
Mailing Address - Country:US
Mailing Address - Phone:956-425-1799
Mailing Address - Fax:888-748-3291
Practice Address - Street 1:305 E JACKSON ST
Practice Address - Street 2:SUITE 112
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-6888
Practice Address - Country:US
Practice Address - Phone:956-425-1799
Practice Address - Fax:888-748-3291
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist