Individual
MRS. CAROL O LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3201 HIGHWAY 71 E, BASTROP, TX 78602-5126
(512) 751-0753
Mailing address
8408 TYHURST DR, AUSTIN, TX 78749-3522
(512) 751-0753
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
518261
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C59R
BLUE CROSS BLUE SHIELD
TX
01
—
100878100
FIRSTCARE
TX
05
—
152275701
—
TX
01
—
742929703
HUMANA/MILITARY
TX
Enumeration date
10/06/2005
Last updated
05/21/2008
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