Individual
TRACY MARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5414 FREDERICKSBURG RD, SUITE 100, SAN ANTONIO, TX 78229-3641
(210) 541-8281
Mailing address
10122 SILVERWAGON, SAN ANTONIO, TX 78254-6034
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
634797
TX
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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