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General NPI Number Information
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NPI Number | 1376114959
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Entity Type | Individual
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Provider Name | TRACEE J LUCAS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 8588 KATY FWY STE 350
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City | HOUSTON
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State | TX
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Zip | 77024-1853
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Country | US
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Telephone | 281-993-3733
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Fax | 281-648-2200
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Provider Business Mailing Address
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Address Line | 8588 KATY FWY STE 350
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City | HOUSTON
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State | TX
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Zip | 77024-1853
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Country | US
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Telephone | 844-824-8775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1044355
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License Number State | TX
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