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Individual

MARY G GRACIA

Active
Sole proprietor

Provider details

NPI number
Gender
F

Contact information

Practice address
17026 BULVERDE RD STE 105, SAN ANTONIO, TX 78247-3176
(210) 981-5543
(972) 980-3738
Mailing address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 475-4426
(360) 475-4344

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
525473
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
525473
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP105341
TX

Other

Enumeration date
11/02/2005
Last updated
03/11/2026
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