Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grace Southern Medical Clinic, PLLC

Organization Primary Care Clinic/Center · NPI 1821486358

Grace Southern Medical Clinic, PLLC is a Primary Care Clinic/Center in Dallas, Texas. Licensed in Texas. Registered with an NPI since 2015.

Licensed in
TX
In the registry since
2015
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6300 Samuell Blvd Ste 120
Dallas, TX 75228-7137
Phone: (214) 381-1910
Fax: (214) 381-2868
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence P4031 (TX)

Record details

NPI number1821486358
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sergio Calixto-Montanez — Member · (214) 381-1910
NPI enumeratedJanuary 7, 2015
Last updated in NPPESJanuary 7, 2015
Mailing address6300 Samuell Blvd, Ste. 120, Dallas, TX 75228-7137

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