Provider Demographics
NPI:1174847925
Name:TRACY C. WOEHL CRNA, P.C.
Entity Type:Organization
Organization Name:TRACY C. WOEHL CRNA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:CORDELL
Authorized Official - Last Name:WOEHL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:214-686-1558
Mailing Address - Street 1:PO BOX 260995
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-0995
Mailing Address - Country:US
Mailing Address - Phone:214-686-1558
Mailing Address - Fax:972-543-2499
Practice Address - Street 1:3801 W 15TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4737
Practice Address - Country:US
Practice Address - Phone:972-543-2477
Practice Address - Fax:972-543-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX644539367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty