Provider Demographics
NPI:1477448801
Name:TACCETTA, GRACIE (DC)
Entity type:Individual
Prefix:
First Name:GRACIE
Middle Name:
Last Name:TACCETTA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4521 SANDERA LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2038
Mailing Address - Country:US
Mailing Address - Phone:512-660-0351
Mailing Address - Fax:
Practice Address - Street 1:255 S DENTON TAP RD STE 200
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5050
Practice Address - Country:US
Practice Address - Phone:972-556-9595
Practice Address - Fax:972-556-9595
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor