Provider Demographics
NPI:1730787557
Name:MCRAITH, GREGORY MICHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:MICHAEL
Last Name:MCRAITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N AUSTIN PKWY
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-3134
Mailing Address - Country:US
Mailing Address - Phone:979-836-2567
Mailing Address - Fax:979-836-7666
Practice Address - Street 1:303 N AUSTIN PKWY
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-3134
Practice Address - Country:US
Practice Address - Phone:979-836-2567
Practice Address - Fax:979-836-7666
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist