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NPI Code Detail

MEDICARE: MS. MAREAH BERNADETTE LUCIO PA-C

MEDICARE:  MS. MAREAH BERNADETTE LUCIO  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA15686TX

General Provider Information

NPI Number : 1255070322
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAREAH BERNADETTE LUCIO PA-C
Provider Business Mailing Address
First Line : 3911 SPRING BLOOM CT
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3207
Country : US
Telephone Number : 281-691-2057
Fax Number :
Provider Business Practice Location Address
First Line : 915 GESSNER RD STE 500
Second Line :
City : HOUSTON
State : TX
Zip : 77024-2568
Country : US
Telephone Number : 713-468-0303
Fax Number : 713-468-0307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2022
Last Update Date : 12/05/2023

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Directions to “ MS. MAREAH BERNADETTE LUCIO PA-C” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.