MEDICARE: AMBER LUCAS

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
1	163W00000X	Registered Nurse	875446	TX
2	363LF0000X	Family Nurse Practitioner	1218420	TX

General Provider Information

NPI Number	:	1336601392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LUCAS

Provider Business Mailing Address
First Line	:	5560 FM 1640 RD UNIT 1788
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-6086
Country	:	US
Telephone Number	:	409-444-7630
Fax Number	:

Provider Business Practice Location Address
First Line	:	1620 FM 2218 RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-5419
Country	:	US
Telephone Number	:	409-444-7630
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	02/06/2026

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Directions to “ AMBER LUCAS ” Practice Location

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