Individual
ERNEST JANRAE MANGABAT LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
18502 W BELLFORT ST STE 118, RICHMOND, TX 77407-9003
(281) 816-3528
Mailing address
9415 ATWOOD RIDGE LN, ROSENBERG, TX 77469-1938
(361) 816-3518
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2178154
TX
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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