Individual
DR. DALE R LUCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 COUNTY ROAD 1224, CLEBURNE, TX 76033-8505
(817) 641-1777
Mailing address
800 COUNTY ROAD 1224, CLEBURNE, TX 76033-8505
(817) 641-1777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E6131
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046QR
BCBS
TX
05
—
112027101
—
TX
05
—
112027106
—
TX
Enumeration date
11/16/2005
Last updated
07/11/2008
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