MEDICARE: TRACY SCOTT BLAKLEY JR. DC

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	16361	TX

General Provider Information

NPI Number	:	1992509806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY SCOTT BLAKLEY JR. DC

Provider Business Mailing Address
First Line	:	3132 MATLOCK RD STE 305
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2922
Country	:	US
Telephone Number	:	817-290-9444
Fax Number	:

Provider Business Practice Location Address
First Line	:	3132 MATLOCK RD STE 305
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2922
Country	:	US
Telephone Number	:	817-290-9444
Fax Number	:

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

Provider Enumeration Date	:	04/01/2025
Last Update Date	:	04/01/2025

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