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General NPI Number Information
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NPI Number | 1356553531
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Entity Type | Individual
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Provider Name | TRACY ALYSE CARR O.T.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1101 7TH ST
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City | BROWNWOOD
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State | TX
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Zip | 76801-4123
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Country | US
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Telephone | 325-643-1721
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Fax | 325-646-7627
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Provider Business Mailing Address
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Address Line | 137 SHENANDOAH DR
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City | COMANCHE
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State | TX
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Zip | 76442-1819
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Country | US
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Telephone | 325-643-1721
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Fax | 325-646-7627
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 109083
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License Number State | TX
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