MEDICARE: TRACIE PENDARVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1215200191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACIE PENDARVIS

Provider Business Mailing Address
First Line	:	5604 PAMPUS LN
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4951
Country	:	US
Telephone Number	:	318-458-1834
Fax Number	:

Provider Business Practice Location Address
First Line	:	5604 PAMPUS LN
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4951
Country	:	US
Telephone Number	:	318-458-1834
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2012
Last Update Date	:	02/22/2012

Similar Medicare Providers

1023034410 — DR. LESLEY JOSEPHINE DLUGOKINSKI PH.D.
Practice Location Address:

5916 W HEFNER RD , #N
OKLAHOMA CITY, OK
73162-4951

Practice Phone: 405-848-7321
Practice Fax: 405-728-1673

1205037348 — MILA RANOVIC PT
Practice Location Address:

4951 S 925 E
SALT LAKE CITY, UT
84117-5704

Practice Phone: 801-815-3482
Practice Fax:

1649530650 — CARING HANDS TRANSPORTATION SERVICE OF TEXAS
Practice Location Address:

2822 SEDONA CREEK DR
MISSOURI CITY, TX
77459-4951

Practice Phone: 713-417-3702
Practice Fax:

1962759472 — HARRIS INTERNATIONAL LLC
Practice Location Address:

2822 SEDONA CREEK DR
MISSOURI CITY, TX
77459-4951

Practice Phone: 281-741-3960
Practice Fax: 888-789-4528

1730506478 — GITANJALI RANJIT
Practice Location Address:

4951 CHAMBERS STREET, , 6TH FLOOR
NEW YORK CITY, NY
10007-1209

Practice Phone: 201-565-5786
Practice Fax:

1770944498 — RICHARD SCOTT WILEY LPC-MH
Practice Location Address:

4951 HANSEN LN
RAPID CITY, SD
57703-0147

Practice Phone: 605-391-3949
Practice Fax:

Directions to “ TRACIE PENDARVIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.