Organization
STEPHEN B. TUCKER, M.D.
Active
Other names
Professional Technology Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN B TUCKER M.D. (OWNER)
(281) 367-9110
Entity
Organization
Contact information
Practice address
1055 EVERGREEN CIR, THE WOODLANDS, TX 77380-3602
(281) 367-9110
(832) 813-0344
Mailing address
1055 EVERGREEN CIR, THE WOODLANDS, TX 77380-3602
(281) 367-9110
(832) 813-0344
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
F6143
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070002920
RAILROAD MEDICARE
TX
05
—
178810101
—
TX
Enumeration date
06/19/2007
Last updated
11/04/2010
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