Provider Demographics
NPI:1144246877
Name:GRAY, ISABEL (MS, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ISABEL
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:MS, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4793 JACKSON SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304
Mailing Address - Country:US
Mailing Address - Phone:713-305-8073
Mailing Address - Fax:
Practice Address - Street 1:4793 JACKSON SQUARE DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-7506
Practice Address - Country:US
Practice Address - Phone:713-305-8073
Practice Address - Fax:936-828-3475
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX447445363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141933501Medicaid
TX141933501Medicaid
TXS83198Medicare UPIN