Active NPI
Gary Wendell Ray, R. PH.
- Compounding Pharmacy
- Grand Prairie, TX
National Provider Identifier
1497915433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Compounding Pharmacy
- Practice address
- 2505 S Carrier Pkwy
Grand Prairie, TX 75052-5017 - Phone
- (972) 264-0268
- Fax
- (972) 262-1750
- NPI assigned
- Jun 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Compounding Pharmacy | 3336C0004X | Primary |
Addresses
Primary practice location
2505 S Carrier Pkwy
Grand Prairie, TX 75052-5017
Mailing address
2505 S Carrier Pkwy
Grand Prairie, TX 75052-5017
Phone (972) 264-0268
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 141836 | Medicaid | TX |
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
- Credentials
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Pharmacy | Compounding Pharmacy | 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": "1213228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573084800000",
"number": "1497915433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 S CARRIER PKWY",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750525017",
"telephone_number": "972-264-0268",
"fax_number": "972-262-1750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2505 S CARRIER PKWY",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750525017",
"telephone_number": "972-264-0268",
"fax_number": "972-262-1750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAY",
"first_name": "GARY",
"middle_name": "WENDELL",
"credential": "R. PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-12",
"last_updated": "2019-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "141836",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.