| Gray Healthcare Llc | |
|
204 N Lavernia Marion TX 78124-2096 | |
| (830) 200-0131 | |
| (210) 600-5943 |
| Full Name | Gray Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 204 N Lavernia, Marion, Texas |
| Authorized Official Name and Position | Kimberly Marie Gray (PRACTICE OWNER) |
| Authorized Official Contact | 8302000131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gray Healthcare Llc 413 E San Antonio St Unit 24 Marion TX 78124-8002 Ph: (830) 200-0131 | Gray Healthcare Llc 204 N Lavernia Marion TX 78124-2096 Ph: (830) 200-0131 |
| NPI Number | 1942046412 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 08/28/2025 |
| 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)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (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 |