Mechiell Demetrius Tucker, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02092 Issued in TX

Practice address

111 Executive Way Ste 102
Desoto, TX 75115-2388

Phone

(469) 941-4029

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Accommodating Medical Providers of Texas, PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Rockwall, TX
  • NPI 1528394806

  Physician Assistant

  NPD Authorized official
• Dal Post Acute Partners, PLLC

  • Internal Medicine Physician
  • Richardson, TX
  • NPI 1174298350
  Medicare reassignment
• Propercare Internal Medicine PA

  • Internal Medicine Physician
  • Desoto, TX
  • NPI 1922337088
  Medicare reassignment
• Jeffrey a Stone DO PA

  • General Practice Physician
  • Dallas, TX
  • NPI 1619080991
  NPD (past)
• North Texas Inpatient and Geriatric Associates PA

  • Home Infusion Therapy Pharmacy
  • Dallas, TX
  • NPI 1104020494
  NPD (past)
• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814
  NPD (past)
• Quality Physical Medicine & Rehabilitation PA

  • Physical Medicine & Rehabilitation Physician
  • Dallas, TX
  • NPI 1285657270
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1730101783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 BAYSIDE DR",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750875307",
            "telephone_number": "469-951-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EXECUTIVE WAY STE 102",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152388",
            "telephone_number": "469-941-4029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2727 Bolton Boone Dr",
            "address_2": "Ste 107",
            "address_purpose": "LOCATION",
            "city": "DeSoto",
            "state": "TX",
            "postal_code": "751152019",
            "country_code": "US",
            "telephone_number": "214-453-2030",
            "fax_number": "972-283-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Joe Ramsey Blvd E Ste 100",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "TX",
            "postal_code": "754017843",
            "country_code": "US",
            "telephone_number": "903-408-5800",
            "fax_number": "903-455-8232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MECHIELL",
        "middle_name": "DEMETRIUS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• True Healing Hands Inc
• True Love Outreach Center Inc
• True Venture 2000
• Tucker Chiropractic PLLC
• Chad Patrick Tucker, DC
• Charles C Tuen, M.D.
• TVWC
• Dorneisia Tyson
• Pablo V Uceda, MD
• Unity Medical Equipment &Supplies, Inc.

• Physician Assistant in Desoto, TX
• Providers in Desoto, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.