Healthcare Provider Details

I. General information

NPI: 1265937148
Provider Name (Legal Business Name): CLAIRE XIAN HUANG LUCAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2018
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 INNOVATION PARK DR STE 700
FAIRFAX VA
22031-4867
US

IV. Provider business mailing address

8081 INNOVATION PARK DR STE 700
FAIRFAX VA
22031-4867
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-2900
  • Fax: 571-742-2901
Mailing address:
  • Phone: 571-472-2900
  • Fax: 571-742-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101280658
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: