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NPI Code Detail

MEDICARE: MRS. MONICA RENE GRACIA RN

MEDICARE:  MRS. MONICA RENE GRACIA  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse622788TX

General Provider Information

NPI Number : 1457473233
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MONICA RENE GRACIA RN
Provider Business Mailing Address
First Line : 1204 5TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104
Country : US
Telephone Number : 817-336-9450
Fax Number : 817-336-3306
Provider Business Practice Location Address
First Line : 1204 5TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104
Country : US
Telephone Number : 817-336-9450
Fax Number : 817-336-3306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. MONICA RENE GRACIA RN” Practice Location

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