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NPI Code Detail

MEDICARE: LUKAS BOGDEN

MEDICARE: LUKAS BOGDEN
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 AssistantTX

General Provider Information

NPI Number : 1821956020
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUKAS BOGDEN
Provider Business Mailing Address
First Line : 1607 N SUGAR RD APT 3103
Second Line :
City : EDINBURG
State : TX
Zip : 78541-8955
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 COLLEGE PARK AVE
Second Line :
City : DAYTON
State : OH
Zip : 45469-0002
Country : US
Telephone Number : 937-229-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2026
Last Update Date : 01/26/2026

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Directions to “ LUKAS BOGDEN ” Practice Location

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