Grace Clinic of Lubbock

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

25283 Issued in TX

Legal business name

GRACE CLINIC OF LUBBOCK

Practice address

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520

Phone

(806) 740-3305

Fax

(806) 712-1803

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Donald Wayne Anderson Jr.

Title

Assistant Secretary of Enrollments

Phone

(425) 358-9786

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GRACE PHARMACY Doing business as

Tax ID family

Grace Clinic of Lubbock3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Grace Clinic Imaging Department

  • Diagnostic Radiology Physician
  • Lubbock, TX
  • NPI 1558523357
  NPD tax ID
• Grace Clinic of Lubbock

  • Multi-Specialty Clinic/Center
  • Lubbock, TX
  • NPI 1770237042
  NPD tax ID

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1144303264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 676132",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752676132",
            "telephone_number": "806-740-3305",
            "fax_number": "806-712-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-740-3305",
            "fax_number": "806-712-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE CLINIC OF LUBBOCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "25283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2099658",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRACE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey K Gourley, PHARM.D.
• Michael David Gouvion, MD
• Grace Ambulatory Surgery Center LP
• Grace Built Foundation LLC
• Grace Clinic Imaging Department
• Grace Clinic of Lubbock
• Grace Clinic of Lubbock
• Kelly Grace, LCSW
• Lindsey Grace, MSN, APRN, FNP-C
• Candace Lynn Graham

• Community/Retail Pharmacy in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.