Individual
GRACE WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2511 86TH ST, LUBBOCK, TX 79423-3387
(806) 793-5683
(844) 522-0356
Mailing address
2511 86TH ST, LUBBOCK, TX 79423-3387
(806) 793-5683
(844) 522-0356
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
T0676
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/28/2017
Last updated
07/03/2021
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