Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP138068 | TX |
NPI | 1073092797 |
---|---|
Provider Name | Arlena Grays |
First Address | Cypress, TX 77433-7538 |
Second Address | Tomball, TX 77375-4595 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2018 |
Last Update Date | 11/06/2019 |