Provider Demographics
NPI:1023412988
Name:GRAY, JAMES KENT (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KENT
Last Name:GRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14843 BIG OAK BAY RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-7309
Mailing Address - Country:US
Mailing Address - Phone:903-655-0880
Mailing Address - Fax:903-654-6415
Practice Address - Street 1:14843 BIG OAK BAY RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75707-7309
Practice Address - Country:US
Practice Address - Phone:903-655-0880
Practice Address - Fax:903-654-6415
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1415207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine