# ADOLPHUS MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447531876
- **Authorized official:** GRACE STANLEY MD (DIRECTOR)
- **Authorized official phone:** (817) 614-9180

## Contact information

- **Practice address:** 406 E CAMP WISDOM RD, SUITE A, DALLAS, TX 75241
- **Practice address phone:** (682) 478-9117
- **Practice address fax:** (817) 887-2305
- **Mailing address:** 2515 MCKINNEY AVE, SUITE 940, DALLAS, TX 75201-1908
- **Mailing address phone:** (682) 478-9117
- **Mailing address fax:** (817) 887-2305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | N9413 | TX | Yes |

## Other

- **Enumeration date:** 08/30/2011
- **Last updated:** 08/30/2011