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General NPI Number Information
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NPI Number | 1760274807
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Entity Type | Organization
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Legal Business Name | GRACE HEALTH DIRECT PRIMARY CARE, PLLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 6100 COLLEYVILLE BLVD STE 160
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City | COLLEYVILLE
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State | TX
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Zip | 76034-8021
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Country | US
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Telephone | 817-587-9074
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Fax | 817-803-8768
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Provider Business Mailing Address
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Address Line | 6100 COLLEYVILLE BLVD STE 160
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City | COLLEYVILLE
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State | TX
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Zip | 76034-8021
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Country | US
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Telephone | 817-587-9074
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Fax | 817-803-8768
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Authorized Official
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Title or Position | CEO
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Name | DR. ANDREW W. AWAD
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Credential | MD
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Telephone | 817-587-9074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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