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Individual

DR. GRACE MUKAMANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8715 VILLAGE DR STE 418, SAN ANTONIO, TX 78217-5407
(210) 655-3800
(210) 655-3801
Mailing address
8711 VILLAGE DR STE 114, SAN ANTONIO, TX 78217-5419
(210) 655-3800
(210) 655-3801

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
N3913
TX
2084N0600X
Clinical Neurophysiology Physician
N3913
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
210192501
TX
Enumeration date
05/21/2007
Last updated
06/04/2019
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