Individual provider Active NPI

Paul Grayburn, MD

  • Cardiovascular Disease Physician
  • Dallas, TX
National Provider Identifier
1326007477
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
F9495 Issued in TX
Practice address
621 N Hall St
Suite H030
Dallas, TX 75226-1339
Phone
(214) 820-7500
Fax
(214) 820-7533
NPI assigned
Mar 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X F9495 TX Primary

Addresses

Primary practice location

621 N Hall St
Suite H030
Dallas, TX 75226-1339

Mailing address

4525 Bentley Dr
Plano, TX 75093-7150

Other identifiers 1

IdentifierTypeStateIssuer
11908305MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Consultants of Texas Cardiovascular Disease Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1326007477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 BENTLEY DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N HALL ST",
            "address_2": "SUITE H030",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261339",
            "telephone_number": "214-820-7500",
            "fax_number": "214-820-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYBURN",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "F9495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11908305",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.