Healthcare Provider Details

I. General information

NPI: 1730292327
Provider Name (Legal Business Name): GRACE CARE OF TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E AVENUE J
LAMPASAS TX
76550-1211
US

IV. Provider business mailing address

505 W CENTERVILLE RD
GARLAND TX
75041-5445
US

V. Phone/Fax

Practice location:
  • Phone: 512-556-6267
  • Fax: 512-556-6601
Mailing address:
  • Phone: 972-278-3566
  • Fax: 972-840-0888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4906
License Number StateTX

VIII. Authorized Official

Name: MR. DAVID O CROWSON
Title or Position: RECEIVERSHIP
Credential:
Phone: 972-278-3566