Provider Demographics
NPI:1871922583
Name:LUCAS HEARING AND BALANCE CENTER
Entity type:Organization
Organization Name:LUCAS HEARING AND BALANCE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:S
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:817-645-0004
Mailing Address - Street 1:108 N PENDELL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-4838
Mailing Address - Country:US
Mailing Address - Phone:817-645-0001
Mailing Address - Fax:817-645-0054
Practice Address - Street 1:108 N PENDELL AVE
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4838
Practice Address - Country:US
Practice Address - Phone:817-645-0001
Practice Address - Fax:817-645-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-03
Last Update Date:2013-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51496332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1245240225OtherNPI