Individual
GRACE NG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-2707
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
S2856
TX
2086S0102X
Surgical Critical Care Physician
S2856
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2013
Last updated
11/06/2023
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