Walter Dietrich Gracia, M.d., P.a.

NPI 1568643500 - Surgery - 2086S0105X

NPI Details
NPI 1568643500
Enumeration Date 11/19/2007
Last Updated 10/08/2010
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DARIELA DARIELA
Position RECEPTIONIST
Phone (817) 336-9450
Fax (817) 336-3306
Practice Location
1204 5TH AVE
FORT WORTH TX, 76104-4303, US
Phone (817) 336-9450
Fax (817) 336-3306
Business Location
1204 5TH AVE
FORT WORTH TX, 76104-4303, US
Phone (817) 336-9450
Fax (817) 336-3306
Toxanomy
Taxonomy Code 2086S0105X
License State
License Number
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According to our database, Walter Dietrich Gracia, M.d., P.a. NPI is 1568643500, taxonomy code is 2086S0105X Walter Dietrich Gracia, M.d., P.a. physically located at 1204 5th Ave, Fort Worth TX, 76104-4303. NPI Number 1033115704 has the healthcare provider type.

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1568643500 NPI number is provided on an as is basis without warranty of any kind. 1568643500 is maintained by the National Plan & Provider Enumeration System. The contents of Walter Dietrich Gracia, M.d., P.a. are for informational purposes only.