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General NPI Number Information
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NPI Number | 1932425709
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Entity Type | Organization
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Legal Business Name | TRACY C CRNIC MD PA
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 01/02/2014
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Provider Practice Location Address
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Address Line | 603 QUAIL CREEK DRIVE SUITE 100
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City | AMARILLO
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State | TX
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Zip | 79124-1645
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Country | US
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Telephone | 806-331-2020
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Fax | 806-331-2023
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Provider Business Mailing Address
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Address Line | 603 QUAIL CREEK DRIVE SUITE 100
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City | AMARILLO
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State | TX
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Zip | 79124-1645
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Country | US
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Telephone | 806-331-2020
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Fax | 806-331-2023
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Authorized Official
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Title or Position | PRESIDENT
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Name | TRACY CRNIC
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Credential | MD
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Telephone | 806-331-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | L5710
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License Number State | TX
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