Provider Demographics
NPI:1710422597
Name:FLOWERS, TRACY L (MA-SLP/CCC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:L
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:MA-SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 SUMMER LOOP
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4335
Mailing Address - Country:US
Mailing Address - Phone:830-739-4999
Mailing Address - Fax:
Practice Address - Street 1:1009 BARNETT ST
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4699
Practice Address - Country:US
Practice Address - Phone:830-257-2203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist