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Individual

GERALD LEWIS TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
402 ULSTER DR, TYLER, TX 75703-5347
(903) 839-7405
Mailing address
402 ULSTER DR, TYLER, TX 75703-5347
(903) 839-7405

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5066
TX

Other

Enumeration date
10/23/2007
Last updated
10/23/2007
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