Healthcare Provider Details

I. General information

NPI: 1497668917
Provider Name (Legal Business Name): VMC GRACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E FM 1187 STE A
CROWLEY TX
76036-4364
US

IV. Provider business mailing address

921 E FM 1187 STE A
CROWLEY TX
76036-4364
US

V. Phone/Fax

Practice location:
  • Phone: 817-297-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. MAGGIE MANKARIOUS
Title or Position: PHARMACIST
Credential:
Phone: 817-297-2000