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General NPI Number Information
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NPI Number | 1932790961
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Entity Type | Individual
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Provider Name | GRACE KANALY VERGES
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Gender | Female
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 8915 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75235-1717
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Country | US
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Telephone | 972-489-4634
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Fax |
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Provider Business Mailing Address
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Address Line | 1348 HEIGHTS BLVD, HOUSTON, TX 77008 1348 HEIGHTS BLVD, HOUSTON, TX 77008
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City | HOUSTON
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State | TX
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Zip | 77008
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Country | US
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Telephone | 713-973-2800
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 106995
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License Number State | TX
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