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NPI Code Detail

MEDICARE: TRACY MANFORD CARLSON M.ED.

MEDICARE: TRACY MANFORD CARLSON M.ED.
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1326990490
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY MANFORD CARLSON M.ED.
Provider Business Mailing Address
First Line : 3514 PALM GROVE DR
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-3051
Country : US
Telephone Number : 713-518-5516
Fax Number :
Provider Business Practice Location Address
First Line : 16225 PARK TEN PL STE 500
Second Line :
City : HOUSTON
State : TX
Zip : 77084-5152
Country : US
Telephone Number : 832-844-1513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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