Individual
LUIS LUCENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 E FERGUSON ST, TYLER, TX 75702-5759
(903) 590-2040
Mailing address
1406 GOLIAD ST, TYLER, TX 75701-7500
(903) 363-3279
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2083935
TX
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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