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NPI Code Detail

MEDICARE: ANTHONY ALLEN LUCIO OTR/L

MEDICARE: ANTHONY ALLEN LUCIO OTR/L
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
1225X00000XOccupational Therapist118402TX

General Provider Information

NPI Number : 1699202515
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY ALLEN LUCIO OTR/L
Provider Business Mailing Address
First Line : 15 SONORA CT
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78526-1759
Country : US
Telephone Number : 956-755-9505
Fax Number :
Provider Business Practice Location Address
First Line : 208 STARR ST STE 2
Second Line :
City : MERCEDES
State : TX
Zip : 78570-2736
Country : US
Telephone Number : 956-514-1551
Fax Number : 956-514-1554
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2017
Last Update Date : 05/23/2017

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