Organization
TRACI L. NIVENS, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL ANN HOOD (PRACTICE ADMINISTRATOR)
(972) 378-3153
Entity
Organization
Contact information
Practice address
6124 W PARKER RD, STE 530, PLANO, TX 75093-8122
(972) 378-3153
(972) 378-3154
Mailing address
6124 W PARKER RD, STE 530, PLANO, TX 75093-8122
(972) 378-3153
(972) 378-3154
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K7424
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0033LS
BLUE CROSS BLUE SHIELD
TX
01
—
7708266
AETNA
TX
Enumeration date
01/15/2008
Last updated
01/15/2008
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