Organization Active NPI

Paul a. Grayburn, MD, PA

  • Cardiovascular Disease Physician
  • Dallas, TX
National Provider Identifier
1801228366
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
F9495 Issued in TX
Legal business name
PAUL A. GRAYBURN, MD, PA
Practice address
621 N Hall St
Suite H030
Dallas, TX 75226-1339
Phone
(214) 820-7500
NPI assigned
Aug 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Authorized official

Name
Kelley Hanger
Title
Billing Manager
Phone
(972) 429-7737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

National Provider Directory

National Provider Directory

Locations

621 N Hall St
Ste H030
Dallas, TX 75226
Phone (214) 820-7500

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375747200000",
    "number": "1801228366",
    "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL A. GRAYBURN, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-08-06",
        "status": "A",
        "authorized_official_last_name": "HANGER",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "972-429-7737"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY 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 6, 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.