| NPI | 1568747244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE VERNON TUCKER CEO/Psychiatrist 888-972-2178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P0883) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TX P0883) |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX P0883) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A84067) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A84067) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX P0883) | |
| 2084S0010X Psychiatry & Neurology, Sports Medicine (Licence: TX P0883) | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2012-12-25 |