Individual provider Active NPI

Bryan Michael Tucker, D.O., M.S.

  • Nephrology Physician
  • Houston, TX
National Provider Identifier
1467712943
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
S2523 Issued in TX
Practice address
1504 Taub Loop
Houston, TX 77030-1608
Phone
(713) 873-8890
NPI assigned
May 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 390200000 IN
Internal Medicine Physician 207R00000X S2523 TX
Nephrology Physician 207RN0300X 2017-00156 NC
Student in an Organized Health Care Education/Training Program 390200000X
Nephrology Physician 207RN0300X S2523 TX Primary

Addresses

Primary practice location

1504 Taub Loop
Houston, TX 77030-1608

Mailing address

7200 Cambridge St FL 8
Houston, TX 77030-4202
Phone (713) 798-2500

Other practice location 1

Medical Center Boulevard
Wake Forest Baptist Health- Nephrology
Winston Salem, NC 27101
Phone (203) 688-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190925003474 TX Practitioner - NephrologyPractitioner - Internal Medicine 2466688627 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baylor College of MedicineGroup PAC ID 8224941265, 796 clinicians
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

1504 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-2000

7200 Cambridge St
Suite 8B
Houston, TX 77030-4202
Phone (713) 798-1000

Hospital & facility affiliations

  • Harris Health Hospital, Houston, TX, CCN 450289
  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
390200000INMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Internal Medicine CurrentSince Aug 20, 2019 Accepting new patients
Baylor College of Medicine CurrentSince Aug 20, 2019 Accepting new patients
Baylor College of Medicine Internal Medicine CurrentSince Aug 20, 2019 Accepting new patients
Baylor College of Medicine CurrentSince Aug 20, 2019 Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

1504 Taub Loop
#621
Houston, TX 77030

7200 Cambridge St
#B
Houston, TX 77030
Phone (713) 798-3498

7200 Cambridge St
Fl 8
Houston, TX 77030
Phone (713) 798-2400

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1467712943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CAMBRIDGE ST FL 8",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304202",
            "telephone_number": "713-798-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 TAUB LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301608",
            "telephone_number": "713-873-8890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Medical Center Boulevard",
            "address_2": "Wake Forest Baptist Health- Nephrology",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "27101",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "BRYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-18",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "390200000",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S2523",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "2017-00156",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "S2523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.