Provider Demographics
NPI:1295848349
Name:MONROY, GRACE ANG (MD)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ANG
Last Name:MONROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 926289
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77292-6289
Mailing Address - Country:US
Mailing Address - Phone:713-681-7334
Mailing Address - Fax:713-681-8520
Practice Address - Street 1:2925 W T C JESTER BLVD STE 16
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018
Practice Address - Country:US
Practice Address - Phone:713-681-7334
Practice Address - Fax:713-681-8520
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1572208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113414007Medicaid
TX113414008Medicaid