Organization Active NPI

Graceland Psychiatry Solutions PLLC

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1780559203
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GRACELAND PSYCHIATRY SOLUTIONS PLLC
Practice address
2411 NE Loop 410 Ste 112
San Antonio, TX 78217-6600
Phone
(817) 863-5264
Fax
(817) 863-5264
NPI assigned
Oct 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Femi Popoola, MDNPI 1417307380
Title
Ceo
Phone
(817) 863-5264

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2411 NE Loop 410 Ste 112
San Antonio, TX 78217-6600

Mailing address

2411 NE Loop 410 Ste 112
San Antonio, TX 78217-6600
Phone (817) 863-5264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260123000179 TX Part B Supplier - Clinic/Group Practice 8820575632 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1780559203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 NE LOOP 410 STE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176600",
            "telephone_number": "817-863-5264",
            "fax_number": "817-863-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 NE LOOP 410 STE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176600",
            "telephone_number": "817-863-5264",
            "fax_number": "817-863-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACELAND PSYCHIATRY SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "POPOOLA",
        "authorized_official_first_name": "FEMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-863-5264",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.