Provider Demographics
NPI:1790090314
Name:ARMSTRONG, TRACY WOODRICK (CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:WOODRICK
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W 34TH ST
Mailing Address - Street 2:STE 110
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1202
Mailing Address - Country:US
Mailing Address - Phone:512-346-7600
Mailing Address - Fax:512-346-7603
Practice Address - Street 1:4515 SETON CENTER PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5290
Practice Address - Country:US
Practice Address - Phone:512-346-5562
Practice Address - Fax:512-346-8846
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80334231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB116244Medicare PIN
TXTXB116245Medicare PIN