Provider Demographics
NPI:1891718839
Name:BLEIER, JOSEPH TRACY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:TRACY
Last Name:BLEIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 TRACY LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-5496
Mailing Address - Country:US
Mailing Address - Phone:903-883-5309
Mailing Address - Fax:
Practice Address - Street 1:4215 JOE RAMSEY BLVD
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402
Practice Address - Country:US
Practice Address - Phone:903-408-1260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5972207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0084PTOtherBLUE CROSS BLUE SHIELD
TX8BX882OtherBCBS
TXP00802511OtherRAILROAD
TX127412813Medicaid
NM39877256Medicaid
TX127412804Medicaid
TXP00802511OtherRAILROAD
TXG21750Medicare UPIN
TX127412813Medicaid