Organization Name: | MICHAEL G. TUCKER, DPM |
NPI Number: | 1376778332 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL GEORGE TUCKER (OWNER) |
Mailing Address: | 450 This Way St Suite D Lake Jackson |
State: | TX US |
Postal Code: | 775665152 |
Phone Number: | 9792850505 |
Fax Number: | 9792859355 |
NPI Enumeration Date: | 05/20/2009 |
NPI Last Update Date: | 05/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 1302 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |