Provider Demographics
NPI:1649203704
Name:BY THE GRACE MEDICAL SUPPLY
Entity Type:Organization
Organization Name:BY THE GRACE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:IBIOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-270-0083
Mailing Address - Street 1:8633 W AIRPORT BLVD
Mailing Address - Street 2:1008
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2479
Mailing Address - Country:US
Mailing Address - Phone:713-270-0083
Mailing Address - Fax:713-270-0530
Practice Address - Street 1:8633 W AIRPORT BLVD
Practice Address - Street 2:1008
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2479
Practice Address - Country:US
Practice Address - Phone:713-270-0083
Practice Address - Fax:713-270-0530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies