MEDICARE: DR. TRACY NEASE PIERCE PHARMD

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	183500000X	Pharmacist	50428	TX

General Provider Information

NPI Number	:	1497359665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRACY NEASE PIERCE PHARMD

Provider Business Mailing Address
First Line	:	4522 FREDERICKSBURG RD
Second Line	:
City	:	BALCONES HEIGHTS
State	:	TX
Zip	:	78201-6521
Country	:	US
Telephone Number	:	210-280-0001
Fax Number	:

Provider Business Practice Location Address
First Line	:	4522 FREDERICKSBURG RD
Second Line	:
City	:	BALCONES HEIGHTS
State	:	TX
Zip	:	78201-6521
Country	:	US
Telephone Number	:	210-280-0001
Fax Number	:

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

Provider Enumeration Date	:	11/27/2020
Last Update Date	:	11/27/2020

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