| Provider / Organization | NPI | Date Certified |
|---|---|---|
| TRACY HAMBLIN HENDERSON | 1073839817 | 2010-04-19 |
Tracy Hamblin [F] graduated in 2010 from University Of Utah School Of Medicine and primarily specializes in Sports Medicine.
Tracy Hamblin Henderson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1073839817. Registration indicates Tracy Hamblin Henderson is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Internal Medicine (Internal Medicine: Sports Medicine, ) (Specialist Network, ) (Internal Medicine Sports Medicine, Allopathic & Osteopathic Physicians) (Internal Medicine, ) (Allopathic & Osteopathic Physicians, Orthopaedic Surgery) (Orthopaedic Surgery: Sports Medicine, ) (Specialist Network, ) (Orthopaedic Surgery Sports Medicine, Allopathic & Osteopathic Physicians) (Orthopaedic Surgery, ) (Allopathic & Osteopathic Physicians, Physical Medicine & Rehabilitation) (Physical Medicine & Rehabilitation: Sports Medicine, ) (Specialist Network, ) (Physical Medicine & Rehabilitation Sports Medicine, Allopathic & Osteopathic Physicians) (Physical Medicine & Rehabilitation, ) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine: Sports Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine Sports Medicine, Allopathic & Osteopathic Physicians) (Family Medicine, )
| PECOS ID | 8022237676 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Tracy Hamblin Henderson MD |
| Other Provider Name | Tracy Hamblin |
| Practice Office Address | 110 MARY LOU DRIVE SUITE 100 WILLOW PARK, TX US |
| Practice Office Telephone | 8179302030 |
| Mailing Address | 110 MARY LOU DR STE 100 WILLOW PARK, TX 760878767 US |
| Business Telephone | 8179302030 |
| Business Fax | 8177577333 |
| Code | Practice | License No State |
|---|---|---|
| 207RS0010X | Allopathic & Osteopathic Physicians Internal Medicine Internal Medicine: Sports Medicine Specialist Network Internal Medicine Sports Medicine Allopathic & Osteopathic Physicians Internal Medicine | T8117
TX |
| 207XX0005X | Allopathic & Osteopathic Physicians Orthopaedic Surgery Orthopaedic Surgery: Sports Medicine Specialist Network Orthopaedic Surgery Sports Medicine Allopathic & Osteopathic Physicians Orthopaedic Surgery | MD60450293
WA |
| 2081S0010X | Allopathic & Osteopathic Physicians Physical Medicine & Rehabilitation Physical Medicine & Rehabilitation: Sports Medicine Specialist Network Physical Medicine & Rehabilitation Sports Medicine Allopathic & Osteopathic Physicians Physical Medicine & Rehabilitation | T8117
TX |
| 207QS0010X PRIMARY | Allopathic & Osteopathic Physicians Family Medicine Family Medicine: Sports Medicine Primary Care/Family Planning/APRN/PA Family Medicine Sports Medicine Allopathic & Osteopathic Physicians Family Medicine | T8117
TX |