Individual
MRS. GRACE A UWAGBAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
5828 SOMERTON DR, GRAND PRAIRIE, TX 75052-8590
(817) 983-9986
Mailing address
5828 SOMERTON DR, GRAND PRAIRIE, TX 75052-8590
(817) 983-9986
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
208133
TX
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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