Provider Demographics
NPI:1255624284
Name:DIABETES AMERICA PHYSICIANS INC
Entity type:Organization
Organization Name:DIABETES AMERICA PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:B
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-237-3500
Mailing Address - Street 1:11321 FALLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4232
Mailing Address - Country:US
Mailing Address - Phone:832-237-3500
Mailing Address - Fax:832-237-0200
Practice Address - Street 1:11321 FALLBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4232
Practice Address - Country:US
Practice Address - Phone:832-237-3500
Practice Address - Fax:832-237-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX556259207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty