Healthcare Provider Details

I. General information

NPI: 1871922583
Provider Name (Legal Business Name): LUCAS HEARING AND BALANCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2013
Last Update Date: 11/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N PENDELL AVE
CLEBURNE TX
76033-4838
US

IV. Provider business mailing address

108 N PENDELL AVE
CLEBURNE TX
76033-4838
US

V. Phone/Fax

Practice location:
  • Phone: 817-645-0001
  • Fax: 817-645-0054
Mailing address:
  • Phone: 817-645-0001
  • Fax: 817-645-0054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number51496
License Number StateTX

VIII. Authorized Official

Name: DR. NANCY S. LUCAS
Title or Position: AUDIOLOGIST
Credential: AU.D.
Phone: 817-645-0004