MEDICARE: ROBERT B TUCKER JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	T0025	TX

General Provider Information

NPI Number	:	1790745834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT B TUCKER JR. MD

Provider Business Mailing Address
First Line	:	311 BOWIE ST APT 2114
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-0062
Country	:	US
Telephone Number	:	843-318-6066
Fax Number	:

Provider Business Practice Location Address
First Line	:	16010 PARK VALLEY DR STE 200
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-3576
Country	:	US
Telephone Number	:	512-244-9944
Fax Number	:	512-244-9977

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	06/14/2026

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