Bracy, Juanita Denae
Bracy, Juanita Denae is an individual health care provider with primary practice located at 700 N Pearl St Ste N510 , Dallas TX 75201-2863. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Bracy, Juanita Denae can be contacted via phone (214) 580-7277.Contact Information
Primary practice address
700 N Pearl St Ste N510
Dallas TX 75201-2863
Phone: (214) 580-7277
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 012000864 | Virginia |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | California | |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 306479 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA60497 | California |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA15256 | Texas |
Profile Details
| NPI number | 1396855813 |
|---|---|
| LBN Legal business name | Bracy, Juanita Denae |
| Credentials | PA-C, MPA, ATC, MED. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Apr 3rd, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396855813 | NPPES |
| Virginia | Other | 0126000864 | ATC VIRGINIA LICENSE |
| Virginia | MEDICAID | PA15256 | ATC VIRGINIA LICENSE |
| Virginia | Other | 0070402592 | ATC VIRGINIA LICENSE |
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