Basic Information
| Provider Information | |||||||||
| NPI: | 1891718839 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BLEIER | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | TRACY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4060 TRACY LN | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 754025496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9038835309 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4215 JOE RAMSEY BLVD | ||||||||
| Address2: | EMERGENCY DEPARTMENT | ||||||||
| City: | GREENVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9034081260 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 10/29/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | J5972 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0084PT | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 8BX882 | 01 | TX | BCBS | OTHER | P00802511 | 01 | TX | RAILROAD | OTHER | 127412813 | 05 | TX | MEDICAID | 39877256 | 05 | NM | MEDICAID | 127412804 | 05 | TX | MEDICAID |