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NPI Code Detail

MEDICARE: MR. THOMAS HERBERT LUCAS L.P.C., N.C.C.

MEDICARE: MR. THOMAS HERBERT LUCAS L.P.C., N.C.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorLPC62521TX

General Provider Information

NPI Number : 1326295890
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS HERBERT LUCAS L.P.C., N.C.C.
Provider Business Mailing Address
First Line : 650 W GREEN ST
Second Line :
City : STEPHENVILLE
State : TX
Zip : 76401-3311
Country : US
Telephone Number : 254-965-7806
Fax Number : 254-965-4308
Provider Business Practice Location Address
First Line : 1715 SANTA FE DR
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-6419
Country : US
Telephone Number : 817-599-9337
Fax Number : 817-599-7636
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2008
Last Update Date : 11/19/2009

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