Provider Demographics
NPI:1831072750
Name:DENNIS, GRACE YVONNE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:YVONNE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 WASHINGTON AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76701-1266
Mailing Address - Country:US
Mailing Address - Phone:254-710-2470
Mailing Address - Fax:
Practice Address - Street 1:801 WASHINGTON AVE STE 800
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-1266
Practice Address - Country:US
Practice Address - Phone:254-710-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program