Provider Demographics
NPI:1528230687
Name:TIERCE, MILLARD LUCIEN IV (DO)
Entity Type:Individual
Prefix:DR
First Name:MILLARD
Middle Name:LUCIEN
Last Name:TIERCE
Suffix:IV
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4200 S HULEN ST STE 230
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4924
Mailing Address - Country:US
Mailing Address - Phone:817-315-2550
Mailing Address - Fax:817-732-4660
Practice Address - Street 1:4200 S HULEN ST STE 230
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4924
Practice Address - Country:US
Practice Address - Phone:817-315-2550
Practice Address - Fax:817-732-4660
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN8250207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty