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General NPI Number Information
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NPI Number | 1437234143
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Entity Type | Organization
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Legal Business Name | TRACY CAREY PHD. PA
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1618 WILLIAMS DR STE 2
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City | GEORGETOWN
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State | TX
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Zip | 78628-3660
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Country | US
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Telephone | 512-869-6961
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Fax | 512-869-5639
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Provider Business Mailing Address
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Address Line | 1618 WILLIAMS DR STE 2
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City | GEORGETOWN
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State | TX
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Zip | 78628-3660
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Country | US
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Telephone | 512-869-6961
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Fax | 512-869-5639
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TRACY CAREY
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Credential | PHD
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Telephone | 512-869-6961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 32862
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License Number State | TX
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