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NPI Code Detail

MEDICARE: LUCAS LEAL DPT

MEDICARE: LUCAS LEAL DPT
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
1225100000XPhysical Therapist1348949TX
22251X0800XOrthopedic Physical TherapistOR230977TX

General Provider Information

NPI Number : 1649944018
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCAS LEAL DPT
Provider Business Mailing Address
First Line : 1001 12TH AVE STE 201
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3946
Country : US
Telephone Number : 817-719-7714
Fax Number : 817-796-1114
Provider Business Practice Location Address
First Line : 1001 12TH AVE STE 201
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3946
Country : US
Telephone Number : 817-719-7714
Fax Number : 817-796-1114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2021
Last Update Date : 12/22/2025

Similar Medicare Providers

1346332251 — MR. JOESPH GEORGE SAHL PT
Practice Location Address:
1001 12TH AVE STE 201
FORT WORTH, TX
76104-3946
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Practice Fax:
1104072065 — DR. SCOTT MCCAULEY DPT, ECS
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1001 12TH AVE STE 201
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1427492941 — DR. KENNETH WHEELER DPT, OCS, NCS
Practice Location Address:
1001 12TH AVE STE 201
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76104-3946
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1235618869 — EMILY E WASCOMB DPT
Practice Location Address:
1001 12TH AVE STE 201
FORT WORTH, TX
76104-3946
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Practice Fax:
1083239305 — DR. RYAN STEPHEN ROESSLER DPT
Practice Location Address:
1001 12TH AVE STE 201
FORT WORTH, TX
76104-3946
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Practice Fax:
1184396764 — JAVIER HERNANDEZ LMT
Practice Location Address:
1001 12TH AVE STE 201
FORT WORTH, TX
76104-3946
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Practice Fax:

Directions to “ LUCAS LEAL DPT” Practice Location

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