MEDICARE: MRS. GRACIELA HERNANDEZ SANCHEZ R.D., L.D.

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
1	133V00000X	Registered Dietitian	DT07655	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487759601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GRACIELA HERNANDEZ SANCHEZ R.D., L.D.

Provider Business Mailing Address
First Line	:	11625 CUSTER RD STE 110504
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-8783
Country	:	US
Telephone Number	:	214-945-3757
Fax Number	:	888-373-1936

Provider Business Practice Location Address
First Line	:	11625 CUSTER RD # 110-504
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-8783
Country	:	US
Telephone Number	:	214-945-3757
Fax Number	:	888-373-1936

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	07/17/2024

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