Gray Chiropractic PLLC
Organization Active NPI Chiropractor · Borger, TX
NPI 1003969924 · NPPES record last updated Oct 30, 2007
Key facts
- NPI
- 1003969924
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- GRAY CHIROPRACTIC PLLC
- Practice address
- 229 Deahl St
Borger, TX 79007-4707 - Phone
- (806) 273-3366
- Fax
- (806) 273-2532
- NPI assigned
- Jan 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Kent D. Gray, D.C.
- Title
- Manager
- Phone
- (806) 273-3366
Practitioners 1
-
Randy Scott Gray, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050912000153 | TX | Part B Supplier - Clinic/Group Practice | 3678506672 |
Receives reassigned benefits from 1 practitioner Practice locations: Borger, TX |
National Provider Directory
Locations
229 Deahl St
Borger, TX 79007
Phone (806) 273-3366
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
229 Deahl St
Borger, TX 79007-4707
Mailing address
PO Box 1127
Borger, TX 79008-1127
Phone (806) 273-3366
Other providers in Borger, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.