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NPI Code Detail

MEDICARE: TRACIE L SMITH

MEDICARE: TRACIE L SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker60746TX

General Provider Information

NPI Number : 1447503982
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACIE L SMITH
Provider Business Mailing Address
First Line : PO BOX 77264
Second Line :
City : FORT WORTH
State : TX
Zip : 76177-0264
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7400 MERTON MINTER ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-4404
Country : US
Telephone Number : 210-617-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2012
Last Update Date : 06/17/2026

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Directions to “ TRACIE L SMITH ” Practice Location

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