Provider Demographics
NPI:1992855126
Name:BAKER, TRACEY R (MPT)
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:R
Last Name:BAKER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 GARTH RD
Mailing Address - Street 2:STE 109
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3900
Mailing Address - Country:US
Mailing Address - Phone:832-556-7750
Mailing Address - Fax:281-832-0841
Practice Address - Street 1:2802 GARTH RD
Practice Address - Street 2:STE 109
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3900
Practice Address - Country:US
Practice Address - Phone:832-556-7750
Practice Address - Fax:281-832-0841
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11660492251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T5325Medicare UPIN