Organization Active NPI

Tracc, PA

  • Trauma Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1619928223
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
Legal business name
TRACC, PA
Practice address
757 8TH Ave Ste 1
Fort Worth, TX 76104-2522
Phone
(817) 332-9957
Fax
(817) 336-3130
NPI assigned
May 16, 2006
Last updated
Aug 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Authorized official

Name
Dr. David C Smith, M.D.NPI 1093767865
Title
President
Phone
(817) 332-9957

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0127X Primary

Addresses

Primary practice location

757 8TH Ave Ste 1
Fort Worth, TX 76104-2522

Mailing address

PO Box 1559
Granbury, TX 76048-8559
Phone (817) 332-9957

Other identifiers 1

IdentifierTypeStateIssuer
079753201MedicaidTX

National Provider Directory

National Provider Directory

Locations

757 8th Ave
Ste 1
Fort Worth, TX 76104
Phone (817) 332-9957

1325 Pennsylvania Ave
Ste 200
Ft Worth, TX 76104
Phone (817) 250-4235

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1619928223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760488559",
            "telephone_number": "817-332-9957",
            "fax_number": "817-336-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 8TH AVE STE 1",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042522",
            "telephone_number": "817-332-9957",
            "fax_number": "817-336-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-332-9957",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079753201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.