Individual
LIBERTAD IVETTE GRACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 SPRING AVE, DALLAS, TX 75210-1350
(214) 865-3061
Mailing address
105 PALOMINO DR, FATE, TX 75087-6881
(214) 244-5843
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
48021-PT19
TX
Other
Enumeration date
11/10/2020
Last updated
09/11/2025
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