MEDICARE: DR. MARIA LUCCHESE DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	1802	TX

General Provider Information

NPI Number	:	1770593469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA LUCCHESE DPM

Provider Business Mailing Address
First Line	:	6000 SHEPHERD MOUNTAIN CV APT 509
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78730-4902
Country	:	US
Telephone Number	:	646-320-8212
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 SHEPHERD MOUNTAIN CV APT 509
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78730-4902
Country	:	US
Telephone Number	:	646-320-8212
Fax Number	:

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/08/2007

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