MEDICARE: TRACEY L WEST D.C.

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
1	111N00000X	Chiropractor	7891	TX

General Provider Information

NPI Number	:	1902814189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY L WEST D.C.

Provider Business Mailing Address
First Line	:	8801 FALCON CREST DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-6732
Country	:	US
Telephone Number	:	214-293-3207
Fax Number	:	940-686-8000

Provider Business Practice Location Address
First Line	:	1017 N HIGHWAY 377
Second Line	:	SUITE A
City	:	PILOT POINT
State	:	TX
Zip	:	76258-4043
Country	:	US
Telephone Number	:	940-686-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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