Organization
BETTY CHUNG GRASTY MD PA
Active
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
Update your record
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