Active NPI
Taylor Jon Gray Sr., OD
- Optometrist
- El Paso, TX
National Provider Identifier
1083454789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11136
- Practice address
- 959 Sunland Park Dr
El Paso, TX 79922-1323 - Phone
- (915) 542-0297
- NPI assigned
- May 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11136 | TX | Primary |
Addresses
Primary practice location
959 Sunland Park Dr
El Paso, TX 79922-1323
Mailing address
6709 Hermoso del Sol
El Paso, TX 79911-3020
Phone (806) 443-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11136 | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1083454789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6709 HERMOSO DEL SOL",
"city": "EL PASO",
"state": "TX",
"postal_code": "799113020",
"telephone_number": "806-443-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "959 SUNLAND PARK DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799221323",
"telephone_number": "915-542-0297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "TAYLOR",
"middle_name": "JON",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-30",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "11136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
- Mark Amir Grant, DO
- Michael Grant, DDS
- Victoria Grasso, D.O.
- Morris Russell Graves III, D.M.D.
- Gabrielle Gray, RBT
- Greater Dallas Healthcare Enterprises
- Greater Dallas Healthcare Enterprises
- Greater Dallas Healthcare Enterprises
- Greater Dallas Healthcare Enterprises
- Greater Dallas Healthcare Enterprises
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.