Individual
ANITRA C TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 GATEHOUSE DR, RED OAK, TX 75154-8873
(469) 951-9996
Mailing address
202 GATEHOUSE DR, RED OAK, TX 75154-8873
(469) 951-9996
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
6366
TX
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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