Provider Demographics
NPI:1568057768
Name:WILLIAMS, TRACY (ATP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 BARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8430
Mailing Address - Country:US
Mailing Address - Phone:972-984-0389
Mailing Address - Fax:
Practice Address - Street 1:1404 BARBOUR DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-8430
Practice Address - Country:US
Practice Address - Phone:972-984-0389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other