Basic Information
Provider Information
NPI: 1104042621
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIGLAN
FirstName: TRACY
MiddleName: A.
NamePrefix: MS.
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FIGLAN
OtherFirstName: TRACY
OtherMiddleName: ANNE
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: R.N.
OtherLastNameType: 5
Mailing Information
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124457787
FaxNumber: 5124404059
Practice Location
Address1: 56 EAST AVE
Address2:  
City: AUSTIN
State: TX
PostalCode: 787014323
CountryCode: US
TelephoneNumber: 5128043481
FaxNumber: 5128043479
Other Information
ProviderEnumerationDate: 04/17/2007
LastUpdateDate: 11/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XAP128539TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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