Active NPI
Tracy Byerly II MD PA
- Otolaryngology Physician
- Fredericksburg, TX
National Provider Identifier
1689142127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- Legal business name
- TRACY BYERLY II MD PA
- Practice address
- 205 W Windcrest St Ste 210
Fredericksburg, TX 78624-4480 - Phone
- (830) 997-4000
- Fax
- (830) 997-2028
- NPI assigned
- Nov 2, 2018
- Organization subpart
- Yes
- Parent organization
- TRACY BYERLY II, MD PA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Katie Durham
- Title
- Billing Coordinator
- Phone
- (830) 997-4000
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | Primary | ||
| Clinic/Center | 261Q00000X |
Addresses
Primary practice location
205 W Windcrest St Ste 210
Fredericksburg, TX 78624-4480
Mailing address
205 W Windcrest St Ste 210
Fredericksburg, TX 78624-4480
Phone (830) 997-4000
Other practice location 1
500 Thompson Dr
Kerrville, TX 78028-5144
Phone (830) 997-4000 ext. 2057
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427354208 | Other | TX | BCBS |
Other names 1
- Sinus ENT Center of Texas
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Part of
- Tracy Byerly II MD PA
Locations
205 W Windcrest Dr
Ste 210
Fredericksburg, TX 78624
811 S Milam St
Fredericksburg, TX 78624
Phone (314) 604-4618
500 Thompson Dr
Ste 1
Kerrville, TX 78028
Phone (830) 997-4000
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JDDGBD
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Otolaryngology Physician
- Fredericksburg, TX
- NPI 1427354208
-
- Physician Assistant
- Kerrville, TX
- NPI 1548631641
-
- Physician Assistant
- Fredericksburg, TX
- NPI 1053396077
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541116800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721001600000",
"number": "1689142127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 W WINDCREST ST STE 210",
"city": "FREDERICKSBURG",
"state": "TX",
"postal_code": "786244480",
"telephone_number": "830-997-4000",
"fax_number": "830-997-2028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 W WINDCREST ST STE 210",
"city": "FREDERICKSBURG",
"state": "TX",
"postal_code": "786244480",
"telephone_number": "830-997-4000",
"fax_number": "830-997-2028"
}
],
"practiceLocations": [
{
"address_1": "500 Thompson Dr",
"address_purpose": "LOCATION",
"city": "Kerrville",
"state": "TX",
"postal_code": "780285144",
"country_code": "US",
"telephone_number": "830-997-4000 x2057",
"fax_number": "830-997-2028",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "TRACY BYERLY II MD PA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRACY BYERLY II, MD PA",
"enumeration_date": "2018-11-02",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A",
"authorized_official_last_name": "DURHAM",
"authorized_official_first_name": "KATIE",
"authorized_official_title_or_position": "BILLING COORDINATOR",
"authorized_official_telephone_number": "830-997-4000"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": true
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1427354208",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sinus ENT Center of Texas",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fredericksburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.