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General NPI Number Information
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NPI Number | 1730292327
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Entity Type | Organization
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Legal Business Name | GRACE CARE OF TEXAS
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1000 E AVENUE J
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City | LAMPASAS
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State | TX
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Zip | 76550-1211
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Country | US
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Telephone | 512-556-6267
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Fax | 512-556-6601
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Provider Business Mailing Address
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Address Line | 505 W CENTERVILLE RD
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City | GARLAND
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State | TX
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Zip | 75041-5445
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Country | US
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Telephone | 972-278-3566
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Fax | 972-840-0888
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Authorized Official
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Title or Position | RECEIVERSHIP
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Name | MR. DAVID O CROWSON
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Credential |
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Telephone | 972-278-3566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 4906
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License Number State | TX
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