His Grace Medical, Llc

NPI 1073898631 - Clinical Medical Laboratory - 291U00000X

NPI Details
NPI 1073898631
Enumeration Date 10/14/2011
Last Updated 10/29/2012
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name EBENEZER EBENEZER
Position PARTNER
Phone (817) 704-8081
Fax
Practice Location
1635 W DIVISION ST
SUITE A
ARLINGTON TX, 76012-3810, US
Phone (817) 704-8081
Fax
Business Location
PO BOX 153202
ARLINGTON TX, 76015-9202, US
Phone
Fax
Toxanomy
Taxonomy Code 291U00000X
License State Texas
License Number 45D1091543
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According to our database, His Grace Medical, Llc NPI is 1073898631, taxonomy code is 291U00000X and license number is 45D1091543, license state is located at Texas. His Grace Medical, Llc physically located at 1635 W Division St, Arlington TX, 76012-3810. NPI Number 1033115704 has the healthcare provider type.

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1073898631 NPI number is provided on an as is basis without warranty of any kind. 1073898631 is maintained by the National Plan & Provider Enumeration System. The contents of His Grace Medical, Llc are for informational purposes only.