Provider Demographics
NPI:1720290448
Name:CHARLES F. GRAY, PH.D., P.C.
Entity Type:Organization
Organization Name:CHARLES F. GRAY, PH.D., P.C.
Other - Org Name:CHUCK GRAY, PH.D. & ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-774-2122
Mailing Address - Street 1:8303 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 330
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1600
Mailing Address - Country:US
Mailing Address - Phone:713-774-2122
Mailing Address - Fax:713-774-3223
Practice Address - Street 1:8303 SOUTHWEST FWY
Practice Address - Street 2:SUITE 330
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1600
Practice Address - Country:US
Practice Address - Phone:713-774-2122
Practice Address - Fax:713-774-3223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16215101Y00000X, 101YM0800X, 101YP1600X, 101YP2500X
TX22982103TB0200X, 103TC0700X, 103TC1900X, 103TF0000X
TX23341103TB0200X, 103TC0700X, 103TC1900X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX07DJOtherBCBS OF TEXAS
TX00590RMedicare ID - Type Unspecified