Most Relevant Information
Provider Data
| NPI Number: | 1003585563 |
| Provider Name: | CONNIE MONTGOMERY TUCKER |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 12054 |
Most Important Dates
| Enumeration Date: | 09/08/2021 |
| Last Updated: | 09/08/2021 |
Provider Practice Location
7095 W WHEATLAND RD
DALLAS
TX
752491067
Practice Location Phone/Fax
| Phone: | 9727082431 |
| Fax: |
Provider Mailing Location
4040 S LEDBETTER DR
DALLAS
TX
752361331
Provider Mailing Phone/Fax
| Phone: | 2146683946 |
| Fax: |