Gray, Mark B

Gray, Mark B is an individual health care provider with primary practice located at 12554 Riata Vista Cir , Austin TX 78727-6431. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as his primary health care specialty. Gray, Mark B can be contacted via phone (512) 795-5100.

Contact Information

Primary practice address
12554 Riata Vista Cir Austin TX 78727-6431
Phone: (512) 795-5100
Fax: (512) 795-5122
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X G6520 Texas

Profile Details

NPI number 1447254222
LBN Legal business name Gray, Mark B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Jan 12th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447254222 NPPES
Other 300127009 RRMCARE2
Other 139655808 RRMCARE2
MEDICAID 139655809 RRMCARE2
MEDICAID 139655816 RRMCARE2
Other 300058890 RRMCARE2
Other 139655815 RRMCARE2

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