Tucker, Mechiell Demetrius

Tucker, Mechiell Demetrius is an individual health care provider with primary practice located at 111 Executive Way Ste 102 , Desoto TX 75115-2388. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Tucker, Mechiell Demetrius can be contacted via phone (469) 941-4029.

Contact Information

Primary practice address
111 Executive Way Ste 102 Desoto TX 75115-2388
Phone: (469) 941-4029
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA02092 Texas

Profile Details

NPI number 1730101783
LBN Legal business name Tucker, Mechiell Demetrius
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Jul 15th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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