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Organization
KINDRELL S. TUCKER, MD, PA
Active
Organization
KINDRELL S. TUCKER, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINDRELL S TUCKER M.D. (OWNER)
(936) 225-3657
Entity
Organization
Contact information
Practice address
305 SHANDS DR, LUFKIN, TX 75904-2885
(936) 225-3657
(936) 899-7293
Mailing address
PO BOX 154137, LUFKIN, TX 75915-4137
(936) 225-3657
(936) 899-7293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
Q3822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245586296
TYPE I NATIONAL PROVIDER IDENTIFIER
—
01
—
1467988600
TYPE II NATIONAL PROVIDER IDENTIFIER
—
Enumeration date
05/09/2017
Last updated
10/02/2025
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