Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | G9491 | TX |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G9491 | TX |
NPI | 1275568610 |
---|---|
Provider Name | Michael J Lucas |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 07/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8F9680 | BCBS (01) | TX |
C18584 | (02) | TX |