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General NPI Number Information
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NPI Number | 1316347628
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Entity Type | Individual
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Provider Name | STEVE TUCKER PHD, ATC
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Gender | Male
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER 3601 4TH STREET STOP 6223
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City | LUBBOCK
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State | TX
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Zip | 79430
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Country | US
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Telephone | 806-743-9967
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Fax |
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Provider Business Mailing Address
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Address Line | TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER 3601 4TH STREET STOP 6223
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City | LUBBOCK
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State | TX
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Zip | 79430
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Country | US
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Telephone | 806-743-9967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT 445
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License Number State | AR
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