Doctor Name: | BRETT ALDON TRACY |
NPI Number: | 1134580251 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-C |
License Number: | AP130262 |
Business Practice Address: | 605 Holderrieth Blvd Tomball, TX - 773756445 |
Business Phone Number: | 2814017695 |
Business Fax Number: | |
Mailing Address: | 10 Sawbridge Cir, THE WOODLANDS |
State: | TX |
Postal Code: | 773895139 |
Phone Number: | 3125454239 |
Fax Number: | |
NPI Enumeration Date: | 03/17/2016 |
NPI Last Update Date: | 03/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP130262 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |