Dejarnette-Holly, Tracie Michele

Dejarnette-Holly, Tracie Michele is an individual health care provider with primary practice located at 22001 Southwest Fwy Ste 125 , Richmond TX 77469-7002. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Forensic Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Dejarnette-Holly, Tracie Michele can be contacted via phone (832) 219-3898.

Contact Information

Primary practice address
22001 Southwest Fwy Ste 125 Richmond TX 77469-7002
Phone: (832) 219-3898
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Forensic Psychiatry 2084F0202X K9516 Texas
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X K9516 Texas
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X K9516 Texas

Profile Details

NPI number 1699786681
LBN Legal business name Dejarnette-Holly, Tracie Michele
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Jun 30th, 2023 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699786681 NPPES
Texas MEDICAID 029799603

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