# HEALING GRACE INTERNAL MEDICINE & PEDIATRICS, LLC

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

## Provider details

- **NPI number:** 1780802504
- **Authorized official:** TONYA CLAYTON M.D. (PRESIDENT)
- **Authorized official phone:** (318) 671-9309

## Contact information

- **Practice address:** 6821 PINES RD, SUITE 200, SHREVEPORT, LA 71129-2547
- **Practice address phone:** (318) 671-9309
- **Practice address fax:** (318) 671-9311
- **Mailing address:** 6821 PINES RD, SUITE 200, SHREVEPORT, LA 71129-2547
- **Mailing address phone:** (318) 671-9309
- **Mailing address fax:** (318) 671-9311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | 023335 | LA | — |
| 207R00000X | Internal Medicine Physician | 023335 | LA | Yes |
| 208000000X | Pediatrics Physician | 023335 | LA | — |

## Other

- **Enumeration date:** 04/24/2007
- **Last updated:** 09/11/2025