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General NPI Number Information
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NPI Number | 1982648820
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Entity Type | Individual
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Provider Name | THOMAS BOYNTON TUCKER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 694 HILL COUNTRY DR
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City | KERRVILLE
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State | TX
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Zip | 78028-6078
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Country | US
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Telephone | 830-792-3434
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Fax | 830-257-5875
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-997-8000
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD60125712
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | G8995
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | G8995
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License Number State | TX
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