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General NPI Number Information
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NPI Number | 1649146580
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Entity Type | Organization
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Legal Business Name | GRACIOUS HEALTH LLC
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 7545 MURPHY RD
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City | SACHSE
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State | TX
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Zip | 75048-2833
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Country | US
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Telephone | 469-326-5782
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Fax | 469-326-5783
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Provider Business Mailing Address
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Address Line | 1005 S CROWLEY RD
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City | CROWLEY
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State | TX
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Zip | 76036-4282
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Country | US
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Telephone | 903-491-6066
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Fax |
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Authorized Official
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Title or Position | SR. MGR. OF RESEARCH & INNOVATION
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Name | JORDAN TYLER
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Credential |
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Telephone | 903-491-6066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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