Individual
DR. WILLIAM FULTON TUCKER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17051 DALLAS PKWY STE 420, ADDISON, TX 75001-7115
(214) 265-5050
(214) 265-0505
Mailing address
PO BOX 12726, DALLAS, TX 75225-0726
(214) 265-5050
(214) 265-0505
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
H8474
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U59Y
BCBS IDENTIFIER
TX
05
—
116145703
—
TX
01
—
200024781
RAILROAD MEDICARE ID
—
01
—
5812005
AETNA ID
—
Enumeration date
01/04/2007
Last updated
10/20/2023
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