Tracey, Thomas Nicholas

Tracey, Thomas Nicholas is an individual health care provider with primary practice located at 4316 James Casey St Building C, Austin TX 78745-1157. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Tracey, Thomas Nicholas can be contacted via phone (512) 623-5300.

Contact Information

Primary practice address
4316 James Casey St Building C Austin TX 78745-1157
Phone: (512) 623-5300
Fax: (512) 623-5399
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X G3861 Texas

Profile Details

NPI number 1780669499
LBN Legal business name Tracey, Thomas Nicholas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Jun 24th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780669499 NPPES
Texas MEDICAID 131767907
Texas Other 060020153
Texas MEDICAID 131767908
Texas Other 8BX079
Texas Other P00706407
Texas MEDICAID 131767902

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