NPIMap

Organization Active NPI

Gratia Plena

  • Clinic/Center
  • Stafford, TX
National Provider Identifier
1053850065
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GRATIA PLENA
Practice address
10707 Corporate Dr
Suite 135
Stafford, TX 77477-4095
Phone
(832) 532-0129
NPI assigned
Feb 23, 2017
Last updated
Feb 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kenneth Buckle, PSY.D.NPI 1770612459
Title
President
Phone
(832) 532-0129

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU

Addresses

Primary practice location

10707 Corporate Dr
Suite 135
Stafford, TX 77477-4095

Mailing address

10707 Corporate Dr
Suite 135
Stafford, TX 77477-4095
Phone (832) 532-0129

National Provider Directory

National Provider Directory

Locations

704 Old Montgomery Rd
Conroe, TX 77301
Phone (836) 539-4004

10707 Corporate Dr
Ste 135
Stafford, TX 77477
Phone (832) 523-0129

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1053850065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10707 CORPORATE DR",
            "address_2": "SUITE 135",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774095",
            "telephone_number": "832-532-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10707 CORPORATE DR",
            "address_2": "SUITE 135",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774095",
            "telephone_number": "832-532-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRATIA PLENA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-23",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "BUCKLE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-532-0129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.