Luckasen, Mary

Luckasen, Mary is an sole proprietor health care provider with primary practice located at 3551 Roger Brooke Dr , Jbsa Ft Sam Houston TX 78234-4504. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Luckasen, Mary can be contacted via phone (210) 916-5910.

Contact Information

Primary practice address
3551 Roger Brooke Dr Jbsa Ft Sam Houston TX 78234-4504
Phone: (210) 916-5910
Fax: (210) 916-2077
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X
Allopathic & Osteopathic Physicians / General Practice 208D00000X DR.0071968 Colorado

Profile Details

NPI number 1366199754
LBN Legal business name Luckasen, Mary
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 4th, 2022
Last updated Oct 14th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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