Michael G. Tucker, DPM

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1302 Issued in TX

Legal business name

MICHAEL G. TUCKER, DPM

Practice address

450 This Way St
Suite D
Lake Jackson, TX 77566-5152

Phone

(979) 285-0505

Fax

(979) 285-9355

NPI assigned

May 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael George Tucker, DPM

Title

Owner

Phone

(979) 285-0505

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1376778332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 THIS WAY ST",
            "address_2": "SUITE D",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665152",
            "telephone_number": "979-285-0505",
            "fax_number": "979-285-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 THIS WAY ST",
            "address_2": "SUITE D",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665152",
            "telephone_number": "979-285-0505",
            "fax_number": "979-285-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL G. TUCKER, DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-285-0505",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00T68L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127186802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.