Individual
GRADA BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2520 HEATHER BROOK LN APT 804, ARLINGTON, TX 76006-5177
(817) 633-0383
(817) 633-0084
Mailing address
PO BOX 540574, GRAND PRAIRIE, TX 75054-0574
(817) 633-0383
(817) 633-0084
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
016187
TX
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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