EAGLE MOUNTAIN HEALTHCARE LLC
NPI 1508563578
Nurse Practitioner - Primary Care in Azle, TX
About Eagle Mountain Healthcare Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAGLE MOUNTAIN HEALTHCARE LLC (NPI 1508563578) is a healthcare organization registered as a primary care in Azle, Texas and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through October 4, 2027 and lists Heather Grayson, Nurse Practitioner/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
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 45D2291112
Eagle Mountain Healthcare · Azle, TXOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Eagle Mountain Healthcare LLC's NPI number?
The NPI number for Eagle Mountain Healthcare LLC is 1508563578. It was assigned to this organization in the NPPES registry on February 10, 2023.
Where is Eagle Mountain Healthcare LLC located?
Eagle Mountain Healthcare LLC is located at 807 Southeast Pkwy, Azle, TX 76020. The listed phone number is (817) 661-8197.
What is Eagle Mountain Healthcare LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Does Eagle Mountain Healthcare LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2291112) is associated with this NPI, valid through October 4, 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 Eagle Mountain Healthcare LLC was last updated on March 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Eagle Mountain Healthcare Llc · NPI 1508563578
Primary Care organization in Azle, Texas. Organization record, active in the CMS NPPES registry since February 10, 2023.
## Identity
- **NPI:** 1508563578 (Entity type: Organization)
- **Enumerated:** February 10, 2023
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **Organization subpart:** No
- **Authorized official:** Heather Grayson, NURSE PRACTITIONER/OWNER
## Practice location
- **Address:** 807 SOUTHEAST PKWY, Azle, TX 76020-3658
- **Phone:** (817) 661-8197
## Record status
- **NPPES last updated:** March 3, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1508563578) · Data from the CMS NPPES public registry.