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General NPI Number Information
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NPI Number | 1700334430
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Entity Type | Individual
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Provider Name | GRACE EWELIKE
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Gender | Female
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Dates
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Enumeration Date | 09/11/2016
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 10925 ESTATE LN SUITE 240
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City | DALLAS
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State | TX
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Zip | 75238-2315
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Country | US
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Telephone | 972-310-6070
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Fax | 214-484-9534
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Provider Business Mailing Address
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Address Line | 9550 SKILLMAN ST STE 200
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City | DALLAS
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State | TX
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Zip | 75243-8282
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Country | US
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Telephone | 972-310-6070
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Fax | 214-666-3057
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 332643
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | 332643
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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