Healthcare Provider Details

I. General information

NPI: 1821056920
Provider Name (Legal Business Name): LUCAS EDWARD SCHREIBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 PASEO DEL PUEBLO SUR SUITE 125
TAOS NM
87571-6070
US

IV. Provider business mailing address

630 PASEO DEL PUEBLO SUR SUITE 125
TAOS NM
87571-6070
US

V. Phone/Fax

Practice location:
  • Phone: 575-751-7430
  • Fax: 575-751-7059
Mailing address:
  • Phone: 575-751-7430
  • Fax: 575-751-7059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2003-0355
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: