Individual
MR. DARREN PAUL STUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3201 UNIVERSITY DR E STE 425, BRYAN, TX 77802-3479
(979) 207-7400
(979) 207-7401
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA14623
TX
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425729701
—
TX
01
—
Q00259715
RR MEDICARE
TX
Enumeration date
04/02/2021
Last updated
03/20/2024
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