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NPI Code Detail

MEDICARE: GRACE CARE OF TEXAS, INC.

MEDICARE: GRACE CARE OF TEXAS, INC.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility112823TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487648382
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE CARE OF TEXAS, INC.
Provider Business Mailing Address
First Line : 505 W CENTERVILLE RD
Second Line :
City : GARLAND
State : TX
Zip : 75041-5445
Country : US
Telephone Number : 972-278-3566
Fax Number : 972-840-1782
Provider Business Practice Location Address
First Line : 505 W CENTERVILLE RD
Second Line :
City : GARLAND
State : TX
Zip : 75041-5445
Country : US
Telephone Number : 972-278-3566
Fax Number : 972-840-1782
Authorized Official
Title or Position : CFO
Name : DONALD J MCKAY
Credential :
Telephone Number : 940-442-6020
Provider Enumeration Date : 09/07/2005
Last Update Date : 08/22/2020

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