Updike, Tracie Dalene
Updike, Tracie Dalene is an sole proprietor health care provider with primary practice located at 2933 Park Plaza Ln , Port Arthur TX 77642-5516. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Updike, Tracie Dalene can be contacted via phone (409) 983-1899.Contact Information
Primary practice address
2933 Park Plaza Ln
Port Arthur TX 77642-5516
Phone: (409) 983-1899
Fax: (409) 983-5225
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | J4577 | Texas |
Profile Details
| NPI number | 1629070750 |
|---|---|
| LBN Legal business name | Updike, Tracie Dalene |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Jul 12th, 2007 - about 17 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 | 1629070750 | NPPES |
| Texas | MEDICAID | 136424202 |
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