Provider Demographics
NPI:1730409137
Name:LUCAS, MINDY SHEREE (PT)
Entity type:Individual
Prefix:MS
First Name:MINDY
Middle Name:SHEREE
Last Name:LUCAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1014 PARIS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CASTROVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78009-2956
Mailing Address - Country:US
Mailing Address - Phone:210-286-3147
Mailing Address - Fax:830-538-3346
Practice Address - Street 1:1014 PARIS ST
Practice Address - Street 2:SUITE A
Practice Address - City:CASTROVILLE
Practice Address - State:TX
Practice Address - Zip Code:78009-2956
Practice Address - Country:US
Practice Address - Phone:210-286-3147
Practice Address - Fax:830-538-3346
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1182563225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist