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MRS. GRACIELA TERESA NIETO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

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

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18511501
TX
Enumeration date
05/28/2006
Last updated
02/13/2017
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