Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GRACE AYANDIBU, M.D, M.S, LPC
Active Sole ProprietorGRACE AYANDIBU, M.D, M.S, LPC is a Procedural Dermatology healthcare provider located in WICHITA FALLS, Texas. NPI 1023395928 is currently active in the NPPES registry. Verify at CMS.
Procedural Dermatology · WICHITA FALLS, TX
Registration Details
- NPI Number
- 1023395928
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 8, 2011 (14.77448483855 yrs)
- Last Updated
- Apr 10, 2023
- Licenses
-
178007242 (IL)T9346 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2637 PLAZA PKWYWICHITA FALLS, TX, 763083889Browse TX providers · Browse ZIP 76308
- Phone
- 9402399160
- Primary Specialty
-
Procedural Dermatology
207NS0135X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Procedural Dermatology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.