Provider Demographics
NPI:1497479380
Name:RANSOM, TRACEY
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:
Last Name:RANSOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 WOODLAND FIELD XING APT 435
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3822
Mailing Address - Country:US
Mailing Address - Phone:832-948-0652
Mailing Address - Fax:
Practice Address - Street 1:1835 WOODLAND FIELD XING APT 435
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3822
Practice Address - Country:US
Practice Address - Phone:832-948-0652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program