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General NPI Number Information
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NPI Number | 1659556173
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Entity Type | Organization
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Legal Business Name | GRACE OB/GYN ASSOCIATES, P.A.
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 403 W CAMPBELL RD SUITE 400
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City | RICHARDSON
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State | TX
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Zip | 75080-3465
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Country | US
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Telephone | 972-231-3898
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Fax |
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Provider Business Mailing Address
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Address Line | 403 W CAMPBELL RD SUITE 400
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City | RICHARDSON
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State | TX
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Zip | 75080-3465
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Country | US
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Telephone | 972-231-3898
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA J YALE
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Credential | M.D.
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Telephone | 972-231-3898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | L9024
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License Number State | TX
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