Provider Demographics
NPI:1134897275
Name:CATER, BORDEN GRAY
Entity type:Individual
Prefix:
First Name:BORDEN
Middle Name:GRAY
Last Name:CATER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 BECKHAM DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-1721
Mailing Address - Country:US
Mailing Address - Phone:334-590-9129
Mailing Address - Fax:
Practice Address - Street 1:1617 BECKHAM DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-1721
Practice Address - Country:US
Practice Address - Phone:334-590-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health