Provider Demographics
NPI:1528222346
Name:GRAY, MARY CATHERINE (PT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:CATHERINE
Last Name:GRAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:CATHERINE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4401 LONG PRAIRIE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1794
Mailing Address - Country:US
Mailing Address - Phone:972-691-1331
Mailing Address - Fax:972-691-1731
Practice Address - Street 1:4401 LONG PRAIRIE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1794
Practice Address - Country:US
Practice Address - Phone:972-691-1331
Practice Address - Fax:972-691-1731
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1181693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist