Individual
MS. TRACIE MCLAIN THORNTON
Active
Individual
MS. TRACIE MCLAIN THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA09498
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
436657YV3C
MEDICARE P-TAN
TX
01
—
436657ZP6S
MEDICARE P-TAN
TX
01
—
8235NV
BCBS - XCITE SURGICAL
TX
01
—
8353NR
BCBS - UNIVERSAL SURGICAL ASSISTANTS
TX
01
—
8354NR
BCBS
TX
01
—
8HM768
BCBS - UNIVERSAL SURGICAL PARTNERS
TX
01
—
8LH981
BCBS - BLUE STAR SURGICAL ASSISTANTS LLC
TX
01
—
PA09498
TEXAS MEDICAL BOARD
TX
Enumeration date
09/29/2014
Last updated
07/26/2019
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