Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 1046539 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 1046539 | TX |
NPI | 1003580614 |
---|---|
Provider Name | Mrs. Tracy Quosig |
First Address | Spring, TX 77379-7582 |
Second Address | Houston, TX 77095-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2021 |
Last Update Date | 12/10/2021 |