Individual
LUCAS BOZICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3828 TROUP HWY, TYLER, TX 75703-1726
(903) 581-9666
Mailing address
3828 TROUP HWY, TYLER, TX 75703-1726
(903) 581-9666
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
50177
TX
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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