Jacqueline Heredia Gracia, MD | |
2192 Rosita Valley Rd, Eagle Pass, TX 78852-2503 | |
(830) 421-5349 | |
(830) 421-5417 |
Full Name | Jacqueline Heredia Gracia |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 2192 Rosita Valley Rd, Eagle Pass, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275858227 | NPI | - | NPPES |
691720 | Other | TX | AMERICAN BOARD OF PEDIATRICS CERTIFICATION |
P7646 | Other | TX | TX MEDICAL BOARD PHYSICIAN FULL PERMIT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | P7646 (Texas) | Primary |
Entity Name | Kickapoo Traditional Tribe Of Texas |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821159518 PECOS PAC ID: 9335236330 Enrollment ID: O20090108000738 |
Mailing Address | Practice Location Address |
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Jacqueline Heredia Gracia, MD 2192 Rosita Valley Rd, Eagle Pass, TX 78852-2503 Ph: (830) 421-5349 | Jacqueline Heredia Gracia, MD 2192 Rosita Valley Rd, Eagle Pass, TX 78852-2503 Ph: (830) 421-5349 |
Marvic Maria Taborda Alvarez, Pediatrics Medicare: Medicare Enrolled Practice Location: 4018 El Indio Hwy, Eagle Pass, TX 78852 Phone: 830-872-3460 Fax: 830-872-3470 | |
Dr. Gaston Ittay Zylberg, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 2525 N Veterans Blvd, Eagle Pass, TX 78852 Phone: 830-773-8917 Fax: 830-773-6432 | |
Eduardo Jose Quintanilla Jerez, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1975 N Veterans Blvd Ste 5, Eagle Pass, TX 78852 Phone: 830-773-9449 | |
Dr. Guillermo Augusto Urueta, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2198 E Garrison St, Eagle Pass, TX 78852 Phone: 830-773-7662 Fax: 830-773-7664 | |
Dr. Janet E. Boone, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4018 El Indio Hwy, Eagle Pass, TX 78852 Phone: 830-872-3460 Fax: 830-872-3470 | |
Ricardo De Los Santos, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 710 Williams St, Eagle Pass, TX 78852 Phone: 830-773-1103 Fax: 830-757-8366 |