Healthcare Provider Details

I. General information

NPI: 1679388359
Provider Name (Legal Business Name): GRACE REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 KRONA DR STE 110
PLANO TX
75074-8325
US

IV. Provider business mailing address

624 KRONA DR STE 110
PLANO TX
75074-8325
US

V. Phone/Fax

Practice location:
  • Phone: 409-626-1491
  • Fax:
Mailing address:
  • Phone: 972-689-2997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: NATHAN SUTTI SUTTI
Title or Position: OWNER
Credential: CPO
Phone: 972-689-2997