Provider Demographics
NPI:1790806156
Name:GRAY, DAWN MARIE (PT, DPT, CERT MDT)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:GRAY
Suffix:
Gender:F
Credentials:PT, DPT, CERT MDT
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:KISSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3930 NAAMAN SCHOOL RD STE D
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-0980
Mailing Address - Country:US
Mailing Address - Phone:469-814-8126
Mailing Address - Fax:972-905-5516
Practice Address - Street 1:3930 NAAMAN SCHOOL RD STE D
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-0980
Practice Address - Country:US
Practice Address - Phone:469-814-8126
Practice Address - Fax:972-905-5516
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007018567225100000X
KS11-03614225100000X
TX1296763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1296763OtherPHYSICAL THERAPY
932255OtherPTAN