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Individual
TRACEY A. HAAS
Active
Individual
TRACEY A. HAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12820A
WY
207Q00000X
Family Medicine Physician
DR.0056096
CO
207Q00000X
Family Medicine Physician
M0100
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056096
MEDICAL LICENSE
CO
01
—
12820A
MEDICAL LICENSE
WY
05
—
181979903
—
TX
05
—
181979904
—
TX
01
—
M0100
TX STATE LICENSE
TX
Enumeration date
07/27/2006
Last updated
03/11/2024
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