Individual
MICHELLE S TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1821 GOLDEN TRAIL CT STE 200, CARROLLTON, TX 75010-4675
(972) 492-2222
(972) 492-4453
Mailing address
1821 GOLDEN TRAIL CT STE 200, CARROLLTON, TX 75010-4675
(972) 492-2222
(972) 492-4453
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L6687
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190764401
—
TX
Enumeration date
02/07/2008
Last updated
05/09/2008
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