MEDICARE: TRACY ELMS

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1831860659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY ELMS

Provider Business Mailing Address
First Line	:	1008 BAILEY RANCH RD
Second Line	:
City	:	ALEDO
State	:	TX
Zip	:	76008-3110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1008 BAILEY RANCH RD
Second Line	:
City	:	ALEDO
State	:	TX
Zip	:	76008-3110
Country	:	US
Telephone Number	:	817-441-8711
Fax Number	:

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

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	09/22/2021

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Directions to “ TRACY ELMS ” 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.

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