1942281928 NPI number — MS. TRACY ELIZABETH PAPA DO

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	PAPA
Provider First Name	:	TRACY
Provider Middle Name	:	ELIZABETH
Provider Name Prefix Text	:	MS.
Provider Name Suffix Text	:
Provider Credential Text	:	DO
Provider Gender Code	:	F

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Provider Other First Name	:
Provider Other Middle Name	:
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Provider Other Name Suffix Text	:
Provider Other Credential Text	:
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NPI Number	:	1942281928
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	07/31/2008
NPI Deactivation Reason Code	:
NPI Deactivation Date	:
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Provider First Line Business Mailing Address	:	1250 8TH AVE
Provider Second Line Business Mailing Address	:	SUITE 570
Provider Business Mailing Address City Name	:	FORT WORTH
Provider Business Mailing Address State Name	:	TX
Provider Business Mailing Address Postal Code	:	761044146
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	8173326667
Provider Business Mailing Address Fax Number	:	8175460946

Provider First Line Business Practice Location Address	:	1250 8TH AVE
Provider Second Line Business Practice Location Address	:	SUITE 570
Provider Business Practice Location Address City Name	:	FORT WORTH
Provider Business Practice Location Address State Name	:	TX
Provider Business Practice Location Address Postal Code	:	761044146
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	8173326667
Provider Business Practice Location Address Fax Number	:	8175460946
Provider Enumeration Date	:	11/08/2005

Authorized Official Last Name	:
Authorized Official First Name	:
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• Taxonomy code: 207VM0101X , with the licence number:  H4599 , registered in the state of TX .

• Identifier: D86934 . This identifiers is of the category "".
• Identifier: 131688707 , issued by the state of ( TX ) . This identifiers is of the category "".