NPI age
17 years
Enumerated 2008-07-02
● Active Type 2 · Organization
Subpart
Grace Clinic Imaging Department
Grace Clinic Imaging Department is 1 of 3776 radiology organizations in Texas.
Primary specialty
Radiology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Anderson
Assistant Secretary Of Enrollments
Last NPPES update
2025-05-06
Source: monthly bulk 2026-05
How this organization compares
Across 3776 active radiology providers in Texas.
NPI age
17 years
↓ 2 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2008 → 2026
2008-07Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
4515 Marsha Sharp Fwy
Lubbock, TX 794072520
Mailing address
Po Box 676132
Dallas, TX 752676132
Authorized official
Donald Wayne Anderson
Assistant Secretary Of Enrollments
📞 4253589786
Individual providers at this organization
20 individual providers on file at this primary practice address.
- Emad Ali, MD Internal Medicine NPI 1104251453
- Charla Allen, M.D. Family Medicine NPI 1154688778
- Sixtus Atabong, PA Physician Assistant NPI 1013987155
- Mohammed Bakdash, M.D. Internal Medicine NPI 1629066964
- Bradley Bale, MD Family Medicine NPI 1205912474
- Judith Boomer, PA Physician Assistant NPI 1912960733
- Hemmo Bosscher, M.D. Pain Medicine NPI 1780687517
- Tammy Brewer Pharmacist NPI 1033447941
- Jared Brinker, MD Family Medicine NPI 1053560250
- Amie Brogden, FNP Nurse Practitioner NPI 1922470921
- Ryan Bullard Nurse Practitioner NPI 1588075402
- Duncan Burkholder, MD Obstetrics & Gynecology NPI 1467430405
- Robert Carr, MD Orthopaedic Surgery NPI 1487658977
- Travis Casler, MD Orthopaedic Surgery NPI 1104889948
- Elizabeth Cobb, M.D. Internal Medicine NPI 1629261599
- Christopher Collins, M.D. Family Medicine NPI 1932390960
- Darlene Cornwell Nurse Practitioner NPI 1497094445
- Cody Cox, M.D. Radiology NPI 1538163175
- Chetlen Crossnoe Family Medicine NPI 1538115951
- Douglas Cummins, M.D. Surgery NPI 1518941475
Specialties
-
Radiology PrimaryA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 0608DC | BCBS OUTSIDE IMAGING |
| 01 (TX) | 0031NR | BCBS GROUP NO. |
Practice context
Multi-provider organization. 20 individual providers on file at this primary address.
Subpart of Grace Clinic.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.