Provider Demographics
NPI:1265923759
Name:TUCKER, DANIEL MORGAN (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:MORGAN
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 1:506 E SHEPHERD ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75021
Mailing Address - Country:US
Mailing Address - Phone:307-221-2030
Mailing Address - Fax:
Practice Address - Street 1:600 E 6TH ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854
Practice Address - Country:US
Practice Address - Phone:870-779-6000
Practice Address - Fax:870-779-6093
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK38022207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine