Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | S7992 | TX |
NPI | 1003310236 |
---|---|
Provider Name | Lucas Mark Alexander |
First Address | Temple, TX 76508 |
Second Address | Temple, TX 76508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2018 |
Last Update Date | 21/01/2021 |