# DR TRACIS HOUSE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Doctor Tracis House
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417834110
- **Authorized official:** TRACI LYNN THOMPSON (CEO)
- **Authorized official phone:** (813) 510-5105

## Contact information

- **Practice address:** 904 E HENRY AVE, TAMPA, FL 33604-7143
- **Practice address phone:** (813) 510-5105
- **Mailing address:** 904 E HENRY AVE, TAMPA, FL 33604-7143
- **Mailing address phone:** (813) 510-5105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251V00000X | Voluntary or Charitable Agency | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/18/2025
- **Last updated:** 11/20/2025