| Grace Southern Medical Clinic, Pllc | |
|
6300 Samuell Blvd Ste. 120 Dallas TX 75228-7137 | |
| (214) 381-1910 | |
| (214) 381-2868 |
| Full Name | Grace Southern Medical Clinic, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6300 Samuell Blvd, Dallas, Texas |
| Authorized Official Name and Position | Sergio Calixto-montanez (MEMBER) |
| Authorized Official Contact | 2143811910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Southern Medical Clinic, Pllc 6300 Samuell Blvd Ste. 120 Dallas TX 75228-7137 Ph: (214) 381-1910 | Grace Southern Medical Clinic, Pllc 6300 Samuell Blvd Ste. 120 Dallas TX 75228-7137 Ph: (214) 381-1910 |
| NPI Number | 1821486358 |
|---|---|
| Provider Enumeration Date | 01/07/2015 |
| Last Update Date | 01/07/2015 |
| Medicare PECOS PAC ID | 0840504197 |
|---|---|
| Medicare Enrollment ID | O20150731014571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821486358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | P4031 (Texas) | Primary |
| Provider Name | Walter Rios |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205865722 PECOS PAC ID: 3678556305 Enrollment ID: I20040611001136 |
| Provider Name | Sergio Calixto-montanez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316268162 PECOS PAC ID: 7416184684 Enrollment ID: I20131213000678 |
Perry K. Beckstrom, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3946 S Buckner Blvd Ste 200, Dallas, TX 75227 Phone: 214-381-7194 Fax: 214-381-7195 | |
John A. Demopulos, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7777 Forest Ln Ste B216, Dallas, TX 75230 Phone: 972-566-8380 | |
North Dallas Orthopedics & Rehabilitation, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7777 Forest Ln, C-500, Dallas, TX 75230 Phone: 972-566-6366 Fax: 972-392-2011 | |
Oakcliff Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 817 W Jefferson Blvd, Dallas, TX 75208 Phone: 214-941-5777 Fax: 214-941-5131 | |
Premier Medical Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8300 Douglas Ave Suite 800, Dallas, TX 75225 Phone: 817-381-6813 | |
Metroplex Geriatric Associates Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9229 Lyndon B Johnson Fwy, Suite 250, Dallas, TX 75243 Phone: 972-739-3097 Fax: 972-739-2673 | |
Family Practice House Calls Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11882 Greenville Ave, Suite B100, Dallas, TX 75243 Phone: 214-865-7331 Fax: 855-237-5132 |