# FORT DAVIS FAMILY PRACTICE, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578757720
- **Authorized official:** DR. JAMES D LUECKE MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (432) 426-3217

## Contact information

- **Practice address:** 1 MEMORIAL SQUARE, BOX 792, FORT DAVIS, TX 79734-0008
- **Practice address phone:** (432) 426-3217
- **Practice address fax:** (432) 426-3084
- **Mailing address:** PO BOX 792, 1 MEMORIAL SQUARE, FORT DAVIS, TX 79734-0008
- **Mailing address phone:** (432) 426-3217
- **Mailing address fax:** (432) 426-3084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2007
- **Last updated:** 04/30/2015