Provider Demographics
NPI:1801842414
Name:FRENCH, TRACI (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:TRACI
Middle Name:
Last Name:FRENCH
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:DR
Other - First Name:TRACI
Other - Middle Name:
Other - Last Name:BUXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3809 S GENERAL BRUCE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-1038
Mailing Address - Country:US
Mailing Address - Phone:210-807-4170
Mailing Address - Fax:210-855-3075
Practice Address - Street 1:404 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513
Practice Address - Country:US
Practice Address - Phone:210-807-4170
Practice Address - Fax:210-855-3075
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-2906207Q00000X
SC52321207Q00000X
MD84937207Q00000X
MO2014008185207Q00000X
FLME137487207Q00000X
TXR4043207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205388705Medicaid
AR145375001Medicaid
AR145375001Medicaid
AR57297Medicare PIN
H41932Medicare UPIN