1144342635 NPI number — BLANCA LUCIA GRAY MD PA

Table of content: MR. NEAL LOPEZ FIGUEROA RN (NPI 1801509492)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144342635 NPI number — BLANCA LUCIA GRAY MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BLANCA LUCIA GRAY MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144342635
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14646 COMPASS ST
Provider Second Line Business Mailing Address:
SUITE 8
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78418-6231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-949-8080
Provider Business Mailing Address Fax Number:
361-949-7988

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14646 COMPASS ST
Provider Second Line Business Practice Location Address:
SUITE 8
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78418-6231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-949-8080
Provider Business Practice Location Address Fax Number:
361-949-7988
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GRAY
Authorized Official First Name:
BLANCA
Authorized Official Middle Name:
LUCIA
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
361-949-8080

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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