Healthcare Provider Details

I. General information

NPI: 1487648382
Provider Name (Legal Business Name): GRACE CARE OF TEXAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 W CENTERVILLE RD
GARLAND TX
75041-5445
US

IV. Provider business mailing address

505 W CENTERVILLE RD
GARLAND TX
75041-5445
US

V. Phone/Fax

Practice location:
  • Phone: 972-278-3566
  • Fax: 972-840-1782
Mailing address:
  • Phone: 972-278-3566
  • Fax: 972-840-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number112823
License Number StateTX

VIII. Authorized Official

Name: DONALD J MCKAY
Title or Position: CFO
Credential:
Phone: 940-442-6020