Provider Demographics
NPI:1427065796
Name:ACUFF, TEA E (MD)
Entity type:Individual
Prefix:
First Name:TEA
Middle Name:E
Last Name:ACUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3537 S I 35 E
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6800
Mailing Address - Country:US
Mailing Address - Phone:940-384-4595
Mailing Address - Fax:469-713-0206
Practice Address - Street 1:3537 S I 35 E
Practice Address - Street 2:SUITE 200
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6800
Practice Address - Country:US
Practice Address - Phone:940-384-4595
Practice Address - Fax:469-713-0206
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7342208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1287021Medicaid
TX1287021Medicaid
TX0094LAOtherBCBS
TX8C0023Medicare ID - Type UnspecifiedMEDICARE IND
TX00888WMedicare ID - Type UnspecifiedMEDICARE GROUP #
TX1287021Medicaid