Individual provider · Type 1 NPI

Charles T. Gravely, PA-C

Medical Physician Assistant · Dallas, TX

NPI number 1235307307 Active

Practice location

11910 Greenville Ave, Suite 500
Dallas, TX 75243-3596

Fax (214) 572-7724

Mailing address

11910 Greenville Ave Ste 500
Dallas, TX 75243-9331

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA02247 (TX)

Medical Physician Assistant: Definition to come...

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About NPI 1235307307

Charles T. Gravely, PA-C's National Provider Identifier is 1235307307, issued on Feb 12, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Dallas, TX. The record was last updated on Oct 19, 2026.