Provider Demographics
NPI:1316347628
Name:TUCKER, STEVE (PHD, ATC)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:TUCKER
Suffix:
Gender:M
Credentials:PHD, ATC
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Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Mailing Address - Street 2:3601 4TH STREET STOP 6223
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430
Mailing Address - Country:US
Mailing Address - Phone:806-743-9967
Mailing Address - Fax:
Practice Address - Street 1:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Practice Address - Street 2:3601 4TH STREET STOP 6223
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430
Practice Address - Country:US
Practice Address - Phone:806-743-9967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT 4452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer