Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | F4934 | TX |
NPI | 1023048725 |
---|---|
Provider Name | Dr. Roger J Lunke |
First Address | San Antonio, TX 78229-4850 |
Second Address | San Antonio, TX 78229-4850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 09/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123411404 | (05) | TX |
C18618 | (02) | TX |