Provider Demographics
NPI:1710907969
Name:WRIGHT, TRACEY B (MD)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:B
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:MC 9063
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-7201
Mailing Address - Country:US
Mailing Address - Phone:214-648-3388
Mailing Address - Fax:214-648-3557
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:CHILDREN'S MEDICAL CENTER DALLAS
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-5160
Practice Address - Fax:214-456-6898
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN12302080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0035343Medicaid
PA101032398Medicaid
NJ0035343Medicaid
PA101032398Medicaid