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General NPI Number Information
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NPI Number | 1942297569
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Entity Type | Individual
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Provider Name | TRACY L CANNON-SMITH MD
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Gender | Female
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 5005 S COOPER ST STE 250
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City | ARLINGTON
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State | TX
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Zip | 76017
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Country | US
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Telephone | 866-367-8768
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Fax | 817-541-9540
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Provider Business Mailing Address
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Address Line | 5001 S COOPER ST STE 201
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City | ARLINGTON
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State | TX
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Zip | 76017-5993
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Country | US
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Telephone | 866-367-8768
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Fax | 817-541-9555
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | M1559
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | M1559
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License Number State | TX
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