Healthcare Provider Details

I. General information

NPI: 1336065218
Provider Name (Legal Business Name): GRACEWOOD GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E ARAPAHO RD STE 110
RICHARDSON TX
75081-2763
US

IV. Provider business mailing address

500 E ARAPAHO RD STE 110
RICHARDSON TX
75081-2763
US

V. Phone/Fax

Practice location:
  • Phone: 972-314-3833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: FNU MIR JAVID ALI
Title or Position: OWNER
Credential:
Phone: 972-314-3833