GERALD LEWIS TUCKER
NPI 1972792141
Counselor - Addiction (Substance Use Disorder) in Tyler, TX
Active since October 23, 2007
About Gerald Lewis Tucker NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GERALD LEWIS TUCKER (NPI 1972792141) is an individual addiction (substance use disorder) provider in Tyler, Texas, licensed in Texas (5066) and active in the NPI registry since October 2007.
NPPES Registry Identity
NPI1972792141
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameGERALD LEWIS TUCKER
Location Address402 ULSTER DRTyler, TX 75703-5347
Mailing Address402 Ulster DrTyler, TX 75703-5347 · (903) 839-7405
Phone(903) 839-7405
Sole ProprietorYes
Enumeration DateOctober 23, 2007
✔ NPI 1972792141 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in TX · 5066
402 ULSTER DR, Tyler, TX 75703
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1972792141, enumerated as an "individual" on October 23, 2007.
The provider is located at 402 ULSTER DR TYLER, TX 75703 and the phone number is (903) 839-7405.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
