Provider Demographics
NPI:1134723398
Name:VOLKER, TRACY GENE (RPH)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:GENE
Last Name:VOLKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19995 HIGHWAY 46 W
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6809
Mailing Address - Country:US
Mailing Address - Phone:210-859-1125
Mailing Address - Fax:
Practice Address - Street 1:19995 HIGHWAY 46 W
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6809
Practice Address - Country:US
Practice Address - Phone:830-438-8001
Practice Address - Fax:830-438-8018
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23535183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist