Provider Demographics
NPI:1023148368
Name:SAFF-DOW, TRACY KAREN (PHD)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:KAREN
Last Name:SAFF-DOW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TRACU
Other - Middle Name:KAREN
Other - Last Name:SAFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 BOLSOVER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2590
Mailing Address - Country:US
Mailing Address - Phone:713-986-3300
Mailing Address - Fax:713-986-3553
Practice Address - Street 1:2500 BOLSOVER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2590
Practice Address - Country:US
Practice Address - Phone:713-986-3300
Practice Address - Fax:713-986-3553
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32425103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87013AOtherTX BCBS COMMERCIAL
TX8C82654Medicare ID - Type UnspecifiedTX MEDICARE PROVIDER NUMB