GRACE MEDICAL ASSOCIATION, PA
NPI 1487695631
Internal Medicine in Lewisville, TX

Active since June 09, 2006CLIA 45D0986854 · Waiver
200 W. SOUTHWEST PKWY, LEWISVILLE, TX 75067(972) 420-6777(972) 420-0656 Get Directions Write a Review

NPPES record last updated: June 2, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Grace Medical Association, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE MEDICAL ASSOCIATION, PA (NPI 1487695631) is a healthcare organization registered as an internal medicine in Lewisville, Texas and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through May 22, 2027 and lists Smart O Idemudia, Owner, as its authorized official.

NPPES Registry Identity

NPI1487695631
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameGRACE MEDICAL ASSOCIATION, PA
Location Address200 W. SOUTHWEST PKWYLewisville, TX 75067
Mailing AddressPo Box 292128Lewisville, TX 75029-2128 · (972) 420-6777 · Fax (972) 420-0656
Fax(972) 420-0656
Organization SubpartNo
Authorized OfficialSmart O IdemudiaOwner · (972) 420-6777
Enumeration DateJune 9, 2006
Last NPPES UpdateJune 2, 2014
NPI 1487695631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in TX · J91000
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X · License J91000 (TX)
200 W. SOUTHWEST PKWY, Lewisville, TX 75067

Other Identifiers 5

Other0078DMTX · Blue Cross / Blue Shield
OtherF46614TX · Commercial
Medicare UPINF46614TX
Medicare ID-Type Unspecified00187JTX
Medicaid138993413TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D0986854

Grace Medical Association · Lewisville, TX
Active · expires May 22, 2027
CLIA Number45D0986854
Laboratory TypePhysician Office
Certificate Effective DateMay 23, 2025
Certificate Expiration DateMay 22, 2027
Laboratory DirectorSmart O. Idemudia
Laboratory Phone(972) 420-6777
Laboratory LocationGrace Medical Association200 West Southwest Parkway, Lewisville, TX 75067
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
200 W. SOUTHWEST PKWY
LEWISVILLE, TX 75067

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grace Medical Association, PA's NPI number?

The NPI number for Grace Medical Association, PA is 1487695631. It was assigned to this organization in the NPPES registry on June 9, 2006.

Where is Grace Medical Association, PA located?

Grace Medical Association, PA is located at 200 W. Southwest Pkwy, Lewisville, TX 75067. The listed phone number is (972) 420-6777.

What is Grace Medical Association, PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Grace Medical Association, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D0986854) is associated with this NPI, valid through May 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grace Medical Association, PA was last updated on June 2, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.