Grace Clinic – Family Medicine Physician, NPI 1912953357
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Grace Clinic
3525 19th St
Lubbock, TX 794101202
Phone: (806) 687-8346
Fax: (888) 856-2848
Type: Location
10208 Quaker Ave Ste 200
Lubbock, TX 794248394
Phone: (806) 795-4500
Fax: (806) 516-5400
Type: Location
3838 50th St
Lubbock, TX 794133808
Phone: (806) 792-5522
Fax: (806) 785-6768
Type: Location
3815 23rd St
Lubbock, TX 794101809
Phone: (806) 722-3500
Fax: (806) 796-0689
Type: Location
PO BOX 676132
DALLAS, TX 752676132
Phone: (806) 744-7223
Fax: (806) 740-3325
Type: Mailing
Grace Clinic, 4515, Marsha Sharp Freeway, Lubbock, Lubbock County, Texas, 79407, United States
LUBBOCK, TX 794072520
Phone: (806) 744-7223
Fax: (806) 740-3325
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-06-30 (707 days ago).
Enrollment records
1
Earliest due date
2024-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930085065 | O | Physician - General Practice | TX | 2024-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 79410)
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