MEDICARE: TRACEY CLARK

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	174400000X	Specialist	225700000X	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	225700000X	OTHER	TX	MASSAGE THERAPY

General Provider Information

NPI Number	:	1720449556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY CLARK

Provider Business Mailing Address
First Line	:	2201 MAIN ST
Second Line	:	1200
City	:	DALLAS
State	:	TX
Zip	:	75201-4327
Country	:	US
Telephone Number	:	972-900-2708
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 MAIN ST
Second Line	:	#1200
City	:	DALLAS
State	:	TX
Zip	:	75201-4327
Country	:	US
Telephone Number	:	972-900-2708
Fax Number	:

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

Provider Enumeration Date	:	03/07/2016
Last Update Date	:	03/07/2016

Similar Medicare Providers

1043408297 — SHANNON YVETTE GALES
Practice Location Address:

2201 MAIN ST , #830
DALLAS, TX
75201-4327

Practice Phone: 214-893-4882
Practice Fax:

1457619082 — ZENITH CHILD AND FAMILY WELLNESS CENTER
Practice Location Address:

2201 MAIN ST , SUITE 400-20
DALLAS, TX
75201-4327

Practice Phone: 214-498-2958
Practice Fax:

1487077111 — PHYCARE SERVICES INC
Practice Location Address:

2201 MAIN ST , 1225
DALLAS, TX
75201-4327

Practice Phone: 817-526-2882
Practice Fax:

1407226129 — CLIFTON WRIGHT
Practice Location Address:

2201 MAIN ST , STE1299
DALLAS, TX
75201-4327

Practice Phone: 214-760-1661
Practice Fax: 214-760-1667

1700245404 — PATRIOT MOBILE IMAGING, LLC
Practice Location Address:

2201 MAIN ST , SUITE 1299
DALLAS, TX
75201-4327

Practice Phone: 214-760-1661
Practice Fax: 214-760-1667

1679924807 — PATRIOT MOBILE IMAGING, LLC
Practice Location Address:

2201 MAIN ST , SUITE 1299
DALLAS, TX
75201-4327

Practice Phone: 214-760-1661
Practice Fax: 214-760-1667

Directions to “ TRACEY CLARK ” 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.