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General NPI Number Information
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NPI Number | 1376343095
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Entity Type | Individual
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Provider Name | GRACEANN WALL GARCIA CPHT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 9255 GRISSOM RD
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City | SAN ANTONIO
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State | TX
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Zip | 78251-2805
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Country | US
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Telephone | 210-680-2958
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Fax |
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Provider Business Mailing Address
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Address Line | 331 NECHES BR
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4329
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Country | US
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Telephone | 214-538-8192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 302843
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License Number State | TX
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