Individual
LUCAS KANE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(903) 293-5103
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(903) 293-5103
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
764416
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP129949
TX
Other
Enumeration date
01/10/2016
Last updated
10/02/2023
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