Organization
BETTY CHUNG GRASTY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETTY CHUNG GRASTY MD (PRESIDENT)
(972) 409-0015
Entity
Organization
Contact information
Practice address
701 TUSCAN, SUITE 235, IRVING, TX 75039-3834
(972) 409-0015
Mailing address
4308 FAIRWAY DR, CARROLLTON, TX 75010-3232
(972) 409-0015
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L1871
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0059JQ
BCBS
—
01
—
L1871
TX LICENSE
TX
01
—
R0119630
DPS
TX
Enumeration date
11/09/2007
Last updated
03/07/2023
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