TRACEY CLARK NPI 1720449556

NPI Information

NPI: 1720449556
Provider Name: TRACEY CLARK
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
2201 MAIN ST
#1200
DALLAS, TX
ZIP 75201
Phone: (972) 900-2708
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Tracey Clark is a specialist in Dallas, TX. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Tracey Clark NPI is 1720449556. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2201 MAIN ST
#1200
DALLAS, TX
ZIP 75201-327
Phone: (972) 900-2708

The enumeration date for this NPI number is 3/7/2016 and was last updated on 3/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		225700000X	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	225700000X	OTHER	TEXAS	MASSAGE THERAPY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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