Individual
BETTIE DEGRACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
405 LONDONDERRY DR STE 311, WACO, TX 76712-7922
(254) 537-6550
Mailing address
5704 TUMBLED STONE DR, KILLEEN, TX 76542-5372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA13381
TX
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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