Provider Demographics
NPI:1992248181
Name:TRACI SONN, LLC
Entity type:Organization
Organization Name:TRACI SONN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SONN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-223-1465
Mailing Address - Street 1:85 IH 10 N
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707
Mailing Address - Country:US
Mailing Address - Phone:409-223-1465
Mailing Address - Fax:844-713-2417
Practice Address - Street 1:85 IH 10 N
Practice Address - Street 2:SUITE 102
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707
Practice Address - Country:US
Practice Address - Phone:409-223-1465
Practice Address - Fax:844-713-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020006OtherHCSSA
TX367033301Medicaid