Provider Demographics
NPI:1538424627
Name:STUARDI, TRACY (PHD, LAC)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:STUARDI
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7304 EGANHILL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5907
Mailing Address - Country:US
Mailing Address - Phone:512-937-3667
Mailing Address - Fax:
Practice Address - Street 1:1707 W KOENIG LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1206
Practice Address - Country:US
Practice Address - Phone:512-937-3667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist