| Gray Healthcare Llc | |
|
3235 Harvest Crst Marion TX 78124-1407 | |
| (210) 864-7431 | |
| (210) 600-5943 |
| Full Name | Gray Healthcare Llc |
|---|---|
| Speciality | General Practice |
| Location | 3235 Harvest Crst, Marion, Texas |
| Authorized Official Name and Position | Kimberly Marie Gray (PRACTICE OWNER) |
| Authorized Official Contact | 2108647431 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gray Healthcare Llc 3235 Harvest Crst Marion TX 78124-1407 Ph: (210) 864-7431 | Gray Healthcare Llc 3235 Harvest Crst Marion TX 78124-1407 Ph: (210) 864-7431 |
| NPI Number | 1942046412 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 07/03/2024 |
| Medicare PECOS PAC ID | 4688102163 |
|---|---|
| Medicare Enrollment ID | O20250113000036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942046412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Kimberly Marie Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619633989 PECOS PAC ID: 0345629812 Enrollment ID: I20220614002561 |
Premise Health Of Texas Medical, P.a Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 565 Bolton Rd Rm 1108, Marion, TX 78124 Phone: 830-420-9820 |