Provider Demographics
NPI:1871190892
Name:TUCKER, TAMMI (RPH)
Entity Type:Individual
Prefix:
First Name:TAMMI
Middle Name:
Last Name:TUCKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PEPLOW DR
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:TX
Mailing Address - Zip Code:76706-5326
Mailing Address - Country:US
Mailing Address - Phone:254-662-6403
Mailing Address - Fax:
Practice Address - Street 1:100 PEPLOW DR
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:TX
Practice Address - Zip Code:76706-5326
Practice Address - Country:US
Practice Address - Phone:254-662-6403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist