Provider Demographics
NPI:1881671352
Name:GRAY, CARLOS E (MD)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:E
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 1:2900 S I H 35
Mailing Address - Street 2:STE 108
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5713
Mailing Address - Country:US
Mailing Address - Phone:512-445-5085
Mailing Address - Fax:
Practice Address - Street 1:2900 S I H 35
Practice Address - Street 2:STE 108
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5713
Practice Address - Country:US
Practice Address - Phone:512-445-5085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7768207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000978-01Medicaid
TX1000978-01Medicaid
TXB87972Medicare UPIN