Grace Southern Medical Clinic, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

P4031 Issued in TX

Legal business name

GRACE SOUTHERN MEDICAL CLINIC, PLLC

Practice address

6300 Samuell Blvd Ste 120
Dallas, TX 75228-7100

Phone

(214) 381-1910

Fax

(214) 381-2868

NPI assigned

Jan 7, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sergio Calixto-Montanez, M.D.NPI 1316268162

Title

Member

Phone

(214) 381-1910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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

• Sergio Calixto-Montanez, M.D.

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1316268162

  Multi-Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Angelle Anderson, MD

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1801456728
  Medicare reassignment Care Compare group NPD
• Sarah Jean Campbell, FNP

  • Nurse Practitioner
  • Garland, TX
  • NPI 1346529138
  Medicare reassignment Care Compare group NPD
• Laura Elena Ramirez, PA-C

  • Physician Assistant
  • Dallas, TX
  • NPI 1508469149
  Medicare reassignment Care Compare group
• Walter Rios, MD

  • Family Medicine Physician
  • Garland, TX
  • NPI 1205865722
  Medicare reassignment NPD
• Christabel Obuseh, PA-C

  • Physician Assistant
  • Dallas, TX
  • NPI 1093429193
  Medicare reassignment

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1821486358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 SAMUELL BLVD",
            "address_2": "STE. 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752287137",
            "telephone_number": "214-381-1910",
            "fax_number": "214-381-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 SAMUELL BLVD STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752287100",
            "telephone_number": "214-381-1910",
            "fax_number": "214-381-2868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 N Belt Line Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "TX",
            "postal_code": "751505802",
            "country_code": "US",
            "telephone_number": "214-381-1910",
            "fax_number": "214-381-2868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRACE SOUTHERN MEDICAL CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "CALIXTO-MONTANEZ",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "214-381-1910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "P4031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace in Healings PLLC
• Grace Outreach
• Grace Place Collin LLC
• Grace Place Counseling, PLLC
• Grace Presbyterian Ministries, Inc.
• Grace T. Chu, D.M.D., P.a.
• Grace to You Pediatrics
• Grace-Eden Homecare Services
• Blake Deron Grace
• Brittan Kaylee Grace, CRNA

• Primary Care Clinic/Center in Dallas, TX
• Providers in Dallas, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.