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Individual
TRACE P TEAS
Active
Individual
TRACE P TEAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP136364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380561601
—
TX
01
—
380561602
CSHCN
TX
Enumeration date
02/02/2018
Last updated
09/09/2026
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