Most Relevant Information
Provider Data
| NPI Number: | 1003453135 |
| Provider Name: | TRACEY LEDOUX PHD |
| Entity Type: | Individual |
| Taxonomy Code: | 261QR1100X |
| Specialty: | Clinic/Center |
| License Number: | 33916 |
Most Important Dates
| Enumeration Date: | 12/09/2019 |
| Last Updated: | 12/09/2019 |
Provider Practice Location
3615 LATMA DR
HOUSTON
TX
770254130
Practice Location Phone/Fax
| Phone: | 4057629039 |
| Fax: |
Provider Mailing Location
3875 HOLMAN ST GARRISON GYM RM 104
HOUSTON
TX
772046015
Provider Mailing Phone/Fax
| Phone: | 4057629039 |
| Fax: |