Provider Demographics
NPI:1316835085
Name:TRACY FRYE SOLE MBR
Entity type:Organization
Organization Name:TRACY FRYE SOLE MBR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:806-407-2117
Mailing Address - Street 1:6868 SKY POINTE DR UNIT 2010
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-6112
Mailing Address - Country:US
Mailing Address - Phone:806-407-2117
Mailing Address - Fax:
Practice Address - Street 1:7975 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7942
Practice Address - Country:US
Practice Address - Phone:806-407-2117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty