Organization
TRACY C CRNIC MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY CRNIC MD (PRESIDENT)
(806) 331-2020
Entity
Organization
Contact information
Practice address
603 QUAIL CREEK DRIVE, SUITE 100, AMARILLO, TX 79124-1645
(806) 331-2020
(806) 331-2023
Mailing address
603 QUAIL CREEK DRIVE, SUITE 100, AMARILLO, TX 79124-1645
(806) 331-2020
(806) 331-2023
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L5710
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159256006
MEDICAID TPI INDIVIDUAL
TX
05
—
214649001
—
TX
01
—
TXB102380
MEDICARE INDIVIDUAL
TX
Enumeration date
04/19/2010
Last updated
01/02/2014
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