Organization
IDH MEDICAL PRACTICE, P.A.
Active
Parent organization
IESO DIGITAL HEALTH
Other names
Ieso Digital Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
IESO DIGITAL HEALTH
Authorized official
MR. JOHN TUCKER JR. MS (DIRECTOR OF OPERATIONS)
(214) 277-3969
Entity
Organization
Contact information
Practice address
6363 N STATE HIGHWAY 161 STE 310, IRVING, TX 75038-2262
(214) 277-3969
Mailing address
6363 N STATE HIGHWAY 161 STE 310, IRVING, TX 75038-2262
(214) 277-3969
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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