MEDICARE: DR. LYNETTE LUI O.D

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	152W00000X	Optometrist	T02382	MO

General Provider Information

NPI Number	:	1902803133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNETTE LUI O.D

Provider Business Mailing Address
First Line	:	6599 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5614
Country	:	US
Telephone Number	:	520-544-4393
Fax Number	:	520-544-4393

Provider Business Practice Location Address
First Line	:	6599 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5614
Country	:	US
Telephone Number	:	520-544-4393
Fax Number	:	520-544-4393

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	09/06/2011

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