Active NPI
Grace Pain & Wellness PLLC
- Interventional Pain Medicine Physician
- Plano, TX
National Provider Identifier
1508683202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- Legal business name
- GRACE PAIN & WELLNESS PLLC
- Practice address
- 6101 W Plano Pkwy Ste 200
Plano, TX 75093-8373 - Phone
- (404) 354-0153
- NPI assigned
- Sep 24, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Anthony Thaddeus Clavo, MD
- Title
- Medical Director
- Phone
- (404) 354-0153
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | |||
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | |||
| Interventional Pain Medicine Physician | 208VP0014X | Primary | ||
| Pain Clinic/Center | 261QP3300X |
Addresses
Primary practice location
6101 W Plano Pkwy Ste 200
Plano, TX 75093-8373
Mailing address
4145 Belt Line Rd Ste 212-237
Addison, TX 75001-4324
Phone (404) 354-0153
National Provider Directory
National Provider DirectoryLocations
4145 Belt Line Rd
Ste 212237
Addison, TX 75001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727136000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727136000000",
"number": "1508683202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4145 BELT LINE RD STE 212-237",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014324",
"telephone_number": "404-354-0153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 W PLANO PKWY STE 200",
"city": "PLANO",
"state": "TX",
"postal_code": "750938373",
"telephone_number": "404-354-0153"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRACE PAIN & WELLNESS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-09-24",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A",
"authorized_official_last_name": "CLAVO",
"authorized_official_first_name": "ANTHONY",
"authorized_official_middle_name": "THADDEUS",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "404-354-0153",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology, Pain Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QP3300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Pain",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.