Provider Demographics
NPI:1841293107
Name:ORR, TRAYCE L (DO)
Entity type:Individual
Prefix:
First Name:TRAYCE
Middle Name:L
Last Name:ORR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W RANDOL MILL RD # 2300
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2504
Mailing Address - Country:US
Mailing Address - Phone:817-960-6648
Mailing Address - Fax:817-960-6649
Practice Address - Street 1:800 W RANDOL MILL RD # 2300
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2504
Practice Address - Country:US
Practice Address - Phone:817-960-6648
Practice Address - Fax:817-960-6649
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8702207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX299589YKPWMedicare PIN
8621MOMedicare PIN
G24631Medicare UPIN