Individual
SHAWNEE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2826 FM 241 S, RUSK, TX 75785-5307
(256) 520-0643
Mailing address
2826 FM 241 S, RUSK, TX 75785-5307
(256) 520-0643
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
FPF00001171
TX
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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