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General NPI Number Information
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NPI Number | 1861263584
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Entity Type | Individual
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Provider Name | MS. KAREN SUE LUCKEMEYER
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Gender | Female
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 16400 BLANCO RD
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City | SAN ANTONIO
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State | TX
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Zip | 78232-1902
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Country | US
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Telephone | 210-724-0505
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Fax | 210-699-7995
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Provider Business Mailing Address
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Address Line | 9591 CLOVERDALE
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City | SAN ANTONIO
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State | TX
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Zip | 78250-3406
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Country | US
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Telephone | 210-710-9337
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 108634
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License Number State | TX
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