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NPI Code Detail

MEDICARE: MS. MA VERONICA CONSISTA LUGTU PA-C

MEDICARE: MS. MA VERONICA CONSISTA LUGTU 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 AssistantPA20103TX

General Provider Information

NPI Number : 1548101934
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MA VERONICA CONSISTA LUGTU PA-C
Provider Business Mailing Address
First Line : PO BOX 737786
Second Line :
City : DALLAS
State : TX
Zip : 75373-7786
Country : US
Telephone Number : 214-377-0608
Fax Number : 214-377-0608
Provider Business Practice Location Address
First Line : 1251 E RED BIRD LN STE A
Second Line :
City : DALLAS
State : TX
Zip : 75241-2008
Country : US
Telephone Number : 214-377-0608
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2026
Last Update Date : 04/10/2026

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