Provider Demographics
NPI:1437576345
Name:GRAJALES, WILLIS DENNIS JR (OD OPTOMETRIST)
Entity Type:Individual
Prefix:DR
First Name:WILLIS
Middle Name:DENNIS
Last Name:GRAJALES
Suffix:JR
Gender:M
Credentials:OD OPTOMETRIST
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Mailing Address - Street 1:2436 QUAIL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6625
Mailing Address - Country:US
Mailing Address - Phone:469-469-1338
Mailing Address - Fax:972-292-9969
Practice Address - Street 1:2532 OLD DENTON RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1444
Practice Address - Country:US
Practice Address - Phone:484-288-0315
Practice Address - Fax:972-292-9969
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2023-12-15
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Provider Licenses
StateLicense IDTaxonomies
TX9321T152W00000X
PAOEG002888152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist