Healthcare Provider Details

I. General information

NPI: 1124374970
Provider Name (Legal Business Name): TRACY ANN THOMAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

6431 FANNIN ST MSB 3.020
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 713-873-5437
  • Fax:
Mailing address:
  • Phone: 713-500-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP5575
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: