Provider Demographics
NPI:1790836260
Name:GRAY, BEULAH M (RN)
Entity Type:Individual
Prefix:MRS
First Name:BEULAH
Middle Name:M
Last Name:GRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7426 MACZALI DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-3319
Mailing Address - Country:US
Mailing Address - Phone:281-216-7375
Mailing Address - Fax:281-437-8224
Practice Address - Street 1:7426 MACZALI DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-3319
Practice Address - Country:US
Practice Address - Phone:281-216-7375
Practice Address - Fax:281-437-8224
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX533409163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management