Provider Demographics
NPI:1861782161
Name:PATRICIA H. LUCE MD PA
Entity type:Organization
Organization Name:PATRICIA H. LUCE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:HARPER
Authorized Official - Last Name:LUCE
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:903-641-1164
Mailing Address - Street 1:4002 S LOOP 256
Mailing Address - Street 2:SUITE S
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-8491
Mailing Address - Country:US
Mailing Address - Phone:903-729-2428
Mailing Address - Fax:903-723-2892
Practice Address - Street 1:4002 S LOOP 256
Practice Address - Street 2:SUITE S
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-8491
Practice Address - Country:US
Practice Address - Phone:903-729-2428
Practice Address - Fax:903-723-2892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8036208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130591707Medicaid
TX1304917-09Medicaid
TX1304917-08Medicaid
TXF97841OtherUPIN