Provider Demographics
NPI:1295799492
Name:GRACEFFO, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:GRACEFFO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1908
Mailing Address - Country:US
Mailing Address - Phone:817-784-1238
Mailing Address - Fax:844-292-1463
Practice Address - Street 1:400 W ARBROOK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3176
Practice Address - Country:US
Practice Address - Phone:817-784-1238
Practice Address - Fax:844-292-1463
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG9856207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134430103Medicaid
TXB23104Medicare UPIN
TX134430103Medicaid