Organization
WALTER DIETRICH GRACIA, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DARIELA SANTOS (RECEPTIONIST)
(817) 336-9450
Entity
Organization
Contact information
Practice address
1204 5TH AVE, FORT WORTH, TX 76104-4303
(817) 336-9450
(817) 336-3306
Mailing address
1204 5TH AVE, FORT WORTH, TX 76104-4303
(817) 336-9450
(817) 336-3306
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
11/19/2007
Last updated
10/08/2010
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