Provider Demographics
NPI:1124073655
Name:MAKHLOUF, GRACE A (MD)
Entity type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:A
Last Name:MAKHLOUF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 460569
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-8569
Mailing Address - Country:US
Mailing Address - Phone:713-273-5881
Mailing Address - Fax:713-273-5820
Practice Address - Street 1:1429 HIGHWAY 6 SOUTH
Practice Address - Street 2:STE 103
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5135
Practice Address - Country:US
Practice Address - Phone:713-273-5881
Practice Address - Fax:713-273-5820
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0913174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A0967Medicare ID - Type Unspecified