Provider Demographics
NPI:1235484130
Name:DR. TRACY PIPKIN MD PA
Entity Type:Organization
Organization Name:DR. TRACY PIPKIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-739-9006
Mailing Address - Street 1:2870 LEWIS LN
Mailing Address - Street 2:SUITE 229
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-9379
Mailing Address - Country:US
Mailing Address - Phone:903-739-9006
Mailing Address - Fax:
Practice Address - Street 1:2870 LEWIS LN
Practice Address - Street 2:SUITE 229
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9379
Practice Address - Country:US
Practice Address - Phone:903-739-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5097207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty