Provider Demographics
NPI:1346552908
Name:GRAY, ANNA (LVN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 EAST LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-3408
Mailing Address - Country:US
Mailing Address - Phone:713-672-6019
Mailing Address - Fax:713-672-6019
Practice Address - Street 1:4421 EAST LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-3408
Practice Address - Country:US
Practice Address - Phone:713-672-6019
Practice Address - Fax:713-672-6019
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-11
Last Update Date:2010-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX161318164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse