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General NPI Number Information
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NPI Number | 1679388359
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Entity Type | Organization
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Legal Business Name | GRACE REHAB, INC.
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 624 KRONA DR STE 110
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City | PLANO
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State | TX
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Zip | 75074-8325
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Country | US
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Telephone | 409-626-1491
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Fax |
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Provider Business Mailing Address
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Address Line | 624 KRONA DR STE 110
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City | PLANO
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State | TX
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Zip | 75074-8325
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Country | US
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Telephone | 409-626-1491
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | SPENCER JOHN SMITH
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Credential | CPO, LPO
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Telephone | 469-989-8283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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