Organization
ACCOMMODATING MEDICAL PROVIDERS OF TEXAS, PLLC
Active
Parent organization
ACCOMMODATING MEDICAL PROVIDERS OF TEXAS, PLLC
Other names
Aging with Care l, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACCOMMODATING MEDICAL PROVIDERS OF TEXAS, PLLC
Authorized official
MECHIELL DEMETRIUS TUCKER PA (OWNER)
(469) 951-9984
Entity
Organization
Contact information
Practice address
3008 BAYSIDE DR, ROCKWALL, TX 75087-5307
(469) 951-9984
Mailing address
3008 BAYSIDE DR, ROCKWALL, TX 75087-5307
(469) 951-9984
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
PA02092
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
PA02092
TX
208D00000X
General Practice Physician
PA02092
TX
363A00000X
Physician Assistant
PA02092
TX
363AM0700X
Medical Physician Assistant
PA02092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117763
—
TX
Enumeration date
10/21/2009
Last updated
01/27/2022
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