SUPERIOR GRACE ENTERPRISE LLC (NPI# 1124552864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124552864 |
| Entity Type | Organization |
| Organization Name | SUPERIOR GRACE ENTERPRISE LLC |
| Practice Address |
2005 Bishop Dr Forney TX 75126-4058 |
| Practice Telephone | 2148869766 |
| Mailing Telephone | 2148869766 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | SARAH MOORE (OWNER) |
| Authorized Official Telephone | 2148869766 |
| Authorized Official Credential | LSA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
SA00597 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2005 BISHOP DR |
| City | FORNEY |
| State | TX |
| Zip Code | 75126-4058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225562036 | Sarah Moore | Physician Assistant | 2005 Bishop Dr, Forney, TX 75126-4058 | 2017-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215339 | Stuart Frey | Pharmacist | 802 East Us Hwy 80, Forney, Forney, TEXAS 75126 | 2020-11-03 |
| 1689209975 | Steffani Wooley | Counselor | 106 S. Bois D'arc St., Forney, TX 75126 | 2020-03-06 |
| 1578123402 | Carrie Viola Phillips | Clinical Nurse Specialist | 9478 Homestead Ln., Forney, TX 75126 | 2019-06-13 |
| 1801451901 | Interventional Partners LLC | Podiatrist | 124 East Hwy 80, Ste. 104, Forney, TX 75126 | 2019-05-03 |
| 1881164937 | Precision Sports Physical Therapy | Physical Therapist | 757 E Highway 80, Suite 160, Forney, TX 75126 | 2018-12-03 |
| 1336621374 | Grace Nkolika Ilonuba | Registered Nurse | 1518 Wheatley Way, Forney, TX 75126 | 2018-09-06 |
| 1497235691 | Tanya Jean Antonisse-irwin | Speech-Language Pathologist | 1023 Kimbro Drive, Forney, TX 75126 | 2018-08-16 |
| 1912490491 | Rachel Caroline Casebolt | Counselor | 112 S Bois D Arc St, Forney, TX 75126 | 2018-06-11 |
| 1730676735 | Forney Mirror Lake Dentistry Pllc | Clinic/Center | 845 N. Fm 548, Suite 150, Forney, TX 75126 | 2018-04-16 |
| 1316449366 | Don A Hunt-ford Jr. | Day Training, Developmentally Disabled Services | 2016 Angel Way, Forney, TN 75126 | 2018-03-06 |
| Find all providers in zip 75126 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225562036 | Sarah Moore | Physician Assistant | 2005 Bishop Dr, Forney, TX 75126-4058 | 2017-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133340 | Mark Alan Williams | Physician Assistant | 4814 Lake Livingston Dr, Corpus Christi, TX 78413-5139 | 2020-10-28 |
| 1669081238 | Manuel V Leyva | Physician Assistant | 8407 Sunset Loch Dr, Spring, TX 77379-5121 | 2020-07-29 |
| 1194342212 | Sean Robert Jamieson | Physician Assistant | 2700 E Broad St Ste 200, Mansfield, TX 76063-5899 | 2020-07-06 |
| 1588284194 | Hill Country Surgical Management, Inc | Physician Assistant | 10454 Tippecanoe, San Antonio, TX 78245-3128 | 2020-04-23 |
| 1407475585 | Serenity Surgical Services | Physician Assistant | 3260 Springbok Cir, Frisco, TX 75034-3671 | 2020-04-09 |
| 1720610470 | Surgical Assistants of South Texas | Physician Assistant | 3414 Highway 146 S, La Porte, TX 77571-7400 | 2020-02-11 |
| 1710524103 | R & H Surgical Services, LLC | Physician Assistant | 14507 Parkesgate Dr, Houston, TX 77083-5792 | 2019-12-04 |
| 1639711195 | Landry & Kiejna Surgical Assisting | Physician Assistant | 1120 Business Center Dr Ste 110, Houston, TX 77043-2735 | 2019-10-16 |
| 1912558693 | Chandrant Akshar Pa | Physician Assistant | 400 W Arbrook Blvd Ste 230, Arlington, TX 76014-3174 | 2019-09-24 |
| 1700435831 | Christina A Vogel-rosbrook | Physician Assistant | 4330 Medical Drive, Suite 120, San Antonio, TX 78229-3353 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.