MEDICARE: DR. LUKE A CARLSON MD

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	2085R0204X	Vascular & Interventional Radiology Physician	M9195	TX

General Provider Information

NPI Number	:	1972704807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUKE A CARLSON MD

Provider Business Mailing Address
First Line	:	3920 W WHEATLAND RD STE 108
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3401
Country	:	US
Telephone Number	:	469-341-5997
Fax Number	:

Provider Business Practice Location Address
First Line	:	3920 W WHEATLAND RD STE 108
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3401
Country	:	US
Telephone Number	:	469-341-5997
Fax Number	:

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	04/28/2025

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