Provider Demographics
NPI:1902814189
Name:WEST, TRACEY L (DC)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:L
Last Name:WEST
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 FALCON CREST DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6732
Mailing Address - Country:US
Mailing Address - Phone:214-293-3207
Mailing Address - Fax:940-686-8000
Practice Address - Street 1:1017 N HIGHWAY 377
Practice Address - Street 2:SUITE A
Practice Address - City:PILOT POINT
Practice Address - State:TX
Practice Address - Zip Code:76258-4043
Practice Address - Country:US
Practice Address - Phone:940-686-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor