Individual
RANDALL SCOTT TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C MSN CNOR RNFA
Contact information
Practice address
1800 PARK PLACE AVE, FORT WORTH, TX 76110-1302
(682) 703-5600
Mailing address
533 RIVERBED DR, CROWLEY, TX 76036-3543
(682) 812-0270
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP135853
TX
Other
Enumeration date
03/02/2018
Last updated
06/16/2018
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