Provider Demographics
NPI:1235265299
Name:TUCKER, JAMES (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:TUCKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 BROWN BLVD STE 217 PMB 670
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-4601
Mailing Address - Country:US
Mailing Address - Phone:817-987-1466
Mailing Address - Fax:
Practice Address - Street 1:5920 INTERSTATE 20 W STE 110
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1000
Practice Address - Country:US
Practice Address - Phone:817-987-1466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC3073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor