Individual
DAVID M TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
711 W 38TH ST, BLDG. F, AUSTIN, TX 78705-1121
(512) 458-6121
(512) 452-5567
Mailing address
711 W 38TH ST, BLDG. F, AUSTIN, TX 78705-1121
(512) 458-6121
(512) 452-5567
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2 4175
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004970 02
—
TX
01
—
8F4432
MEDICARE
TX
Enumeration date
09/20/2006
Last updated
11/04/2010
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