Provider Demographics
NPI:1730912890
Name:YU, GRACE (RD)
Entity type:Individual
Prefix:MS
First Name:GRACE
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 PRESTON RD APT 3004
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2579
Mailing Address - Country:US
Mailing Address - Phone:646-464-2929
Mailing Address - Fax:
Practice Address - Street 1:7950 PRESTON RD APT 3004
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2579
Practice Address - Country:US
Practice Address - Phone:646-464-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87551133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered