Active NPI
Bill George Gray I, D.D.S.
- Public Health Dentistry
- Houston, TX
National Provider Identifier
1568795805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 12731
- Practice address
- 5425 Polk St
Suite J, Mail Code 1906
Houston, TX 77023-1497 - Phone
- (713) 767-3471
- Fax
- (713) 767-3036
- NPI assigned
- Sep 17, 2009
- 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 |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 12731 | TX | Primary |
Addresses
Primary practice location
5425 Polk St
Suite J, Mail Code 1906
Houston, TX 77023-1497
Mailing address
2410 Old Dixie Dr
Richmond, TX 77406-6818
Phone (281) 723-3064
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090478101 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12731 | TX | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Department of State Health Services | Past | Accepting new patients | |
| Department of State Health Services | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Texas Center for Infectious Disease
- Clinic/Center
- San Antonio, TX
- NPI 1316000144
-
dba Texas DSHS - HSR 6&5 Houston
- State or Local Public Health Clinic/Center
- Houston, TX
- NPI 1942376066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253145600000",
"number": "1568795805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 OLD DIXIE DR",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774066818",
"telephone_number": "281-723-3064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5425 POLK ST",
"address_2": "SUITE J, MAIL CODE 1906",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770231497",
"telephone_number": "713-767-3471",
"fax_number": "713-767-3036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "BILL",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"name_suffix": "I",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-17",
"last_updated": "2009-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "TX",
"license": "12731",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "090478101",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.