Tracy Dawn Walters, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22338 Issued in TX

Practice address

11115 Wurzbach Rd
San Antonio, TX 78230-2643

Phone

(210) 877-2273

Fax

(210) 561-5500

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• La Tooth Doc

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1699638874
  NPD
• Klenke & Associates, PA

  • Dental Clinic/Center
  • San Antonio, TX
  • NPI 1033660725
  NPD (past)
• Klenke & Associates, PC

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1427174390
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447359104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11115 WURZBACH RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302643",
            "telephone_number": "210-877-2273",
            "fax_number": "210-561-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 WURZBACH RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302643",
            "telephone_number": "210-877-2273",
            "fax_number": "210-561-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "TRACY",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROV. #",
            "identifier": "001774691",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PROV. #",
            "identifier": "46DS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Galus Walters, P.A.
• Bobbie J Walters
• Jessica Anne Walters
• Morgan Walters
• Stacyann Walters
• Eva Lynn G Walthall, LCSW
• Walter Walthall, MD
• Jacob Waltman
• Scott Harris Waltman, PSYD
• Emily Walton

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.