Organization
CARENCIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE TUCKER PMHNP (OWNER)
(817) 478-5333
Entity
Organization
Contact information
Practice address
1215 W RANDOL MILL RD, ARLINGTON, TX 76012-3113
(817) 478-5333
(682) 499-7705
Mailing address
PO BOX 121592, ARLINGTON, TX 76012-1592
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
06/15/2017
Last updated
09/04/2024
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