Provider Demographics
NPI:1720193329
Name:GRAY, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:GRAY
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 1:3600 GASTON AVE
Mailing Address - Street 2:STE 760
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1907
Mailing Address - Country:US
Mailing Address - Phone:214-826-6110
Mailing Address - Fax:214-828-9127
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:STE 760
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1907
Practice Address - Country:US
Practice Address - Phone:214-826-6110
Practice Address - Fax:214-828-9127
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8240207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121460301Medicaid
TX8A0730OtherBLUE CROSS BLUE SHIELD
TX00EH96Medicare PIN
TX8A0730OtherBLUE CROSS BLUE SHIELD