Thomas, Tracy Wayne
Thomas, Tracy Wayne is an sole proprietor health care provider with primary practice located at 2660 E End Blvd S Suite 128, Marshall TX 75672-7404. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Thomas, Tracy Wayne can be contacted via phone (903) 407-9701.Contact Information
Primary practice address
2660 E End Blvd S Suite 128
Marshall TX 75672-7404
Phone: (903) 407-9701
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 19851 | Texas |
Profile Details
| NPI number | 1932320942 |
|---|---|
| LBN Legal business name | Thomas, Tracy Wayne |
| Credentials | M.ED., LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 1st, 2007 |
| Last updated | Feb 20th, 2012 - about 12 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 | 1932320942 | NPPES |
| Texas | MEDICAID | 1762403-01 |
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