Provider Demographics
NPI:1972712719
Name:BARR, TRACEY DIANNE (P T)
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:DIANNE
Last Name:BARR
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 CEDAR RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5032
Mailing Address - Country:US
Mailing Address - Phone:281-316-5880
Mailing Address - Fax:
Practice Address - Street 1:2910 CEDAR RIDGE TRL
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5032
Practice Address - Country:US
Practice Address - Phone:281-316-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist