TRACY LINN EISENHAUER DILLEY (NPI# 1215589726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215589726 |
| Entity Type | Individual |
| Full Name | TRACY LINN EISENHAUER DILLEY |
| Credential | NP |
| Practice Address |
1017 12th Ave Fort Worth TX 76104-3915 |
| Practice Telephone | 8173342800 |
| Practice Fax Number | 8178200094 |
| Mailing Telephone | 8173342800 |
| Mailing Fax Number | 8178200094 |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP142209 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 920 Hilltop Dr, Weatherford, TX 760865488 | 8176139082 | 8178200094 |
| Street Address |
1017 12TH AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-3915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619927373 | George Souhel Khammar | Internal Medicine | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2006-05-11 |
| 1639615347 | Alla Havens | Nurse Practitioner | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2017-01-18 |
| 1063816833 | Danielle L King | Physician Assistant | 1017 12th Ave, Fort Worth, TX 76104 | 2014-10-22 |
| 1629403712 | Kathryn Elizabeth Marcinowski | Physician Assistant | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2013-09-07 |
| 1821339201 | Isadora Galindo Subia | Nurse Practitioner | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2013-03-08 |
| 1558659607 | Carrie S Platt | Nurse Practitioner | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2011-07-11 |
| 1770804981 | Aleem Iqbal Mughal | Internal Medicine | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2010-06-22 |
| 1770710543 | Cyril Varughese | Internal Medicine | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2009-06-18 |
| 1437397478 | Akif Azmi Mohammed | Internal Medicine | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2009-01-29 |
| 1629215587 | Srujana Chakilam | Internal Medicine | 1017 12th Ave, Fort Worth, TX 76104-3915 | 2009-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417556341 | Sarah R Tabor | Nurse Practitioner | 4819 El Campo Ave, Fort Worth, TX 76107-4917 | 2020-10-21 |
| 1336747963 | Thomas Liles | Nurse Practitioner | 4 Carlson Ct, Fort Worth, TX 76119-5901 | 2020-10-15 |
| 1518565597 | Khyatiben Harsh Parikh | Nurse Practitioner | 8121 Belgian Blue Ct, Fort Worth, TX 76131-1734 | 2020-10-13 |
| 1225645906 | Manju Karki K C | Nurse Practitioner | 4812 Meadow Falls Dr # A, Fort Worth, TX 76244-2308 | 2020-09-28 |
| 1497361778 | Mulikat Dossou | Nurse Practitioner | 8024 Valley Crest Dr, Fort Worth, TX 76120-5651 | 2020-09-22 |
| 1275148793 | Bianca Adrianna Agnello | Nurse Practitioner | 8465 Boat Club Rd Ste 115, Fort Worth, TX 76179-3676 | 2020-09-11 |
| 1356955363 | Alba C. Rivas | Nurse Practitioner | 6958 Legato Ln, Fort Worth, TX 76134-3727 | 2020-09-07 |
| 1043824139 | Traci D Huff | Nurse Practitioner | 7121 Sundance Ln, Fort Worth, TX 76179-2533 | 2020-09-04 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1619589108 | Megan King | Nurse Practitioner | 9734 N Beach St Ste 100, Fort Worth, TX 76244-6185 | 2020-08-18 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on TRACY LINN EISENHAUER DILLEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.