Provider Demographics
NPI:1609966928
Name:TUCKER, DAVID MAURY (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MAURY
Last Name:TUCKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25427 BUNKER DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2635
Mailing Address - Country:US
Mailing Address - Phone:210-253-0029
Mailing Address - Fax:
Practice Address - Street 1:14743 JONES MALTSBERGER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3713
Practice Address - Country:US
Practice Address - Phone:210-402-0029
Practice Address - Fax:210-490-8616
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM46082084P0802X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry