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1649271677

NPI Code Detail

MEDICARE: DR. ROBERT J LUEKEN MD

MEDICARE: DR. ROBERT J LUEKEN MD

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
1	207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	0101234866	VA
2	207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	P3761	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	75-0818167-048	OTHER	TX	TRICARE
3	P01118262	OTHER	TX	RAIL ROAD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	75-2616977-001	OTHER	TX	TRICARE
6	8AM874	OTHER	TX	BCBS
7	8DL528	OTHER	TX	BCBS
8	75-0818167-015	OTHER	TX	TRICARE
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	75-0818167-022	OTHER	TX	TRICARE
12	75-1976930-005	OTHER	TX	TRICARE
13	75-2616977-028	OTHER	TX	TRICARE
14	8DU478	OTHER	TX	BCBS
15	75-0818167-044	OTHER	TX	TRICARE
16	8DL531	OTHER	TX	BCBS
17	0101234866	OTHER	VA	MEDICINE AND SURGERY
18	75-2616977-002	OTHER	TX	TRICARE
19	P01118234	OTHER	TX	RAIL ROAD
20	P01304443	OTHER	TX	RAIL ROAD

General Provider Information

NPI Number	:	1649271677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT J LUEKEN MD

Provider Business Mailing Address
First Line	:	PO BOX 841656
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-1656
Country	:	US
Telephone Number	:	903-531-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 E DAWSON ST
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-2036
Country	:	US
Telephone Number	:	903-531-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	10/27/2014

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Directions to “ DR. ROBERT J LUEKEN MD” Practice Location

Language	Start Address	Practice Location

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