Individual
STACIA W LUSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1501 S COULTER ST, AMARILLO, TX 79106-1770
(806) 367-2488
(806) 354-1833
Mailing address
4800 BRIGHTON PL, AMARILLO, TX 79119-4909
(806) 353-2645
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L6103
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184947303
—
TX
Enumeration date
09/08/2006
Last updated
08/09/2022
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