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General NPI Number Information
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NPI Number | 1891890075
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Entity Type | Individual
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Provider Name | ROBERT A LUEDECKE MD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 12790 FM 1560 #755
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City | HELOTES
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State | TX
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Zip | 78023-2232
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Country | US
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Telephone | 210-614-3371
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Fax | 210-614-1055
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Provider Business Mailing Address
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Address Line | PO BOX 240098
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City | SAN ANTONIO
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State | TX
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Zip | 78224-0098
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Country | US
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Telephone | 210-621-0640
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Fax | 210-621-2386
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | F9758
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License Number State | TX
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