HAILEY SUZANNE GRAY (NPI# 1972156750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972156750 |
| Entity Type | Individual |
| Full Name | HAILEY SUZANNE GRAY |
| Credential | PHARMD, RPH |
| Practice Address |
1620 S Broadway Ave Tyler TX 75701-4260 |
| Mailing Address |
315 Susie St Chandler TX 75758-2331 |
| Practice Telephone | 9035330367 |
| Mailing Telephone | 9038051891 |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2019-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 64886 | TX | Pharmacy Service Providers |
| Street Address |
1620 S BROADWAY AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-4260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982845509 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1620 S Broadway Ave, Tyler, TX 75701-4260 | 2009-03-11 |
| 1669086831 | Maylis Peguy L Nkeng Peh | Pharmacist | 1620 S Broadway Ave, Tyler, TX 75701-4260 | 2020-09-03 |
| 1821526948 | Corey Moore | Pharmacist | 1620 S Broadway Ave, Tyler, TX 75701-4260 | 2017-06-02 |
| 1205118981 | Reva A Wilson | Pharmacist | 1620 S Broadway Ave, Tyler, TX 75701-4260 | 2011-09-19 |
| 1215263959 | Stephen Bradley Martin | Pharmacist | 1620 S Broadway Ave, Tyler, TX 75701-4260 | 2009-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073433 | Josephine S Asamoah | Pharmacist | 3820 Tx-64, Tyler, TX 75704-5582 | 2020-11-06 |
| 1790386738 | Jennifer O Jackson | Pharmacist | 1900 Ese Loop323, Tyler, TX 75701-8337 | 2020-11-05 |
| 1528669132 | Youness Ennouri | Pharmacist | 2025 Ssw Loop 323, Tyler, TX 75701-0763 | 2020-11-02 |
| 1194325415 | Rupal R Patel | Pharmacist | 3820 Tx 64, Tyler, TX 75704 | 2020-10-27 |
| 1528673597 | Holly Beth Lutmer | Pharmacist | 4901 Kinsey Dr Apt 1723, Tyler, TX 75703-3033 | 2020-09-15 |
| 1558976498 | Traci Carroll George | Pharmacist | 1600 W Sw Loop 323, Tyler, TX 75701-8532 | 2020-09-08 |
| 1538773213 | Zachary Thompson | Pharmacist | 19201 Oakbrook Rd, Tyler, TX 75703-8233 | 2020-09-01 |
| 1699392407 | Cathlyn Yu | Pharmacist | 13157 Hwy 271, Tyler, TX 75708-2453 | 2020-06-26 |
| 1245878826 | Kim Annette Parks | Pharmacist | 113 Nnw Loop 323, Tyler, TX 75702-8725 | 2019-12-14 |
| 1366003063 | Austin J Dowell | Pharmacist | 4290 Kinsey Dr Ste 100, Tyler, TX 75703-1022 | 2019-06-24 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.