Organization
ADOLPHUS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE STANLEY MD (DIRECTOR)
(817) 614-9180
Entity
Organization
Contact information
Practice address
406 E CAMP WISDOM RD, SUITE A, DALLAS, TX 75241
(682) 478-9117
(817) 887-2305
Mailing address
2515 MCKINNEY AVE, SUITE 940, DALLAS, TX 75201-1908
(682) 478-9117
(817) 887-2305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N9413
TX
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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