Individual
FELICIA GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 S 6TH ST, LA PORTE, TX 77571-4903
(225) 505-8448
Mailing address
201 S 6TH ST, LA PORTE, TX 77571-4903
(225) 505-8448
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
NA0060055777
TX
376K00000X
Nurse's Aide
Primary
NA0060055777
TX
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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