Gray, Jeannie
Gray, Jeannie is an individual health care provider with primary practice located at 3500 N Midkiff Rd Suite 100, Midland TX 79705-4834. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Gray, Jeannie can be contacted via phone (432) 699-1300.Contact Information
Primary practice address
3500 N Midkiff Rd Suite 100
Midland TX 79705-4834
Phone: (432) 699-1300
Fax: (432) 694-1981
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 6390TG | Texas |
Profile Details
| NPI number | 1164435665 |
|---|---|
| LBN Legal business name | Gray, Jeannie |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Feb 17th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164435665 | NPPES |
| Texas | Other | 80899Q | BCBS |
| Texas | MEDICAID | 1614646002 | BCBS |
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