Individual
GONZALO EMMAN GRAJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
2609 NESSUH AVE, EDINBURG, TX 78541-4814
(956) 630-1116
Mailing address
3421 WESTWAY AVE, MCALLEN, TX 78501-5841
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
207164
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207164
—
TX
Enumeration date
06/01/2018
Last updated
06/01/2018
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