# MRS.GRACIELA TERESA NIETO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical X-Ray on Wheels
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972777548
- **Authorized official:** MRS. GRACIELA TERESA NIETO (OWNER)
- **Authorized official phone:** (956) 535-2818

## Contact information

- **Practice address:** 1405 E LYON ST, LAREDO, TX 78040-2733
- **Practice address phone:** (956) 722-9729
- **Practice address fax:** (956) 722-9990
- **Mailing address:** PO BOX 1886, HARLINGEN, TX 78551-1886
- **Mailing address phone:** (956) 722-9729
- **Mailing address fax:** (956) 722-9990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | R29718 | TX | Yes |

## Other

- **Enumeration date:** 04/15/2008
- **Last updated:** 02/13/2017