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Individual

ALEXIS ANN LUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3636 EXECUTIVE CENTER DR STE G70, AUSTIN, TX 78731-1628
(512) 371-9555
(512) 367-5756
Mailing address
12703 S 75TH EAST AVE, BIXBY, OK 74008-1501
(918) 606-2146

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA15472
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
737791
TEXAS MEDICAL BOARD ID
TX
Enumeration date
12/08/2021
Last updated
03/11/2022
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