MEDICARE: D&J GRACE TEAM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	207Q00000X	Family Medicine Physician
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1093062937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D&J GRACE TEAM LLC

Provider Business Mailing Address
First Line	:	921 E FM 1187 STE A
Second Line	:
City	:	CROWLEY
State	:	TX
Zip	:	76036-4364
Country	:	US
Telephone Number	:	682-250-5700
Fax Number	:	682-250-5705

Provider Business Practice Location Address
First Line	:	921 E FM 1187 STE A
Second Line	:
City	:	CROWLEY
State	:	TX
Zip	:	76036-4364
Country	:	US
Telephone Number	:	817-945-1682
Fax Number	:	682-250-5705

Authorized Official
Title or Position	:	OWNER
Name	:	DR. EHAB I HANNA
Credential	:	M.D.
Telephone Number	:	682-250-5700

Provider Enumeration Date	:	08/09/2012
Last Update Date	:	03/19/2026

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Directions to “D&J GRACE TEAM LLC ” Practice Location

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