Individual
PAUL ANTHONY TUCKER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4316 JAMES CASEY ST, BUILDING C, AUSTIN, TX 78745-1116
(512) 623-5300
(512) 623-5399
Mailing address
PO BOX 1509, SAN ANTONIO, TX 78295-1509
(512) 623-5300
(512) 623-5399
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
H3951
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060020998
MEDICARE RAILROAD
TX
05
—
119097701
—
TX
05
—
119097704
—
TX
05
—
119097705
—
TX
01
—
8BX080
BCBSTX
TX
01
—
P00698690
MEDICARE RAILROAD
TX
Enumeration date
12/14/2005
Last updated
01/28/2022
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