MEDICARE: DR. PERCY EDGAR LUECKE III D.D.S., M.S.D.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	15344	TX

General Provider Information

NPI Number	:	1477766061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PERCY EDGAR LUECKE III D.D.S., M.S.D.

Provider Business Mailing Address
First Line	:	4902 GOLDEN QUAIL
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1636
Country	:	US
Telephone Number	:	210-690-0662
Fax Number	:	210-696-8742

Provider Business Practice Location Address
First Line	:	4902 GOLDEN QUAIL
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1636
Country	:	US
Telephone Number	:	210-690-0662
Fax Number	:	210-696-8742

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	04/11/2011

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1588393920 — DR. JAANAVI PARESH DEDHIA
Practice Location Address:

529 SW MILITARY DR
SAN ANTONIO, TX
78221-1636

Practice Phone: 210-547-7191
Practice Fax:

1649263237 — MR. DONALD L. KNOLL M.S.W.
Practice Location Address:

406 WOOD SHADOW ST
SAN ANTONIO, TX
78216-1636

Practice Phone: 210-496-0579
Practice Fax: 210-496-0579

1992990139 — BEXAR COUNTY DENTAL
Practice Location Address:

529 SW MILITARY DR
SAN ANTONIO, TX
78221-1636

Practice Phone: 210-435-6090
Practice Fax: 210-435-7722

1013178813 — DR. RUBEN EDMUND MORA D.D.S.
Practice Location Address:

529 SW MILITARY DR
SAN ANTONIO, TX
78221-1636

Practice Phone: 210-547-7191
Practice Fax: 210-319-1391

1932501251 — MARY VADAKEKALAM
Practice Location Address:

1636 LOCKHILL SELMA RD
SAN ANTONIO, TX
78213-1929

Practice Phone: 210-541-8455
Practice Fax: 210-541-9477

Directions to “ DR. PERCY EDGAR LUECKE III D.D.S., M.S.D.” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.