Provider Demographics
NPI:1538622170
Name:STAMMANN, TRACY RENE (DO)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:RENE
Last Name:STAMMANN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4911 SANDHILL DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5320
Mailing Address - Country:US
Mailing Address - Phone:281-238-7870
Mailing Address - Fax:281-633-4985
Practice Address - Street 1:22001 SOUTHWEST FWY STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-7002
Practice Address - Country:US
Practice Address - Phone:281-239-5037
Practice Address - Fax:281-762-5399
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT4061207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program