Organization
FORT DAVIS FAMILY PRACTICE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES D LUECKE MD (OWNER/PHYSICIAN)
(432) 426-3217
Entity
Organization
Contact information
Practice address
1 MEMORIAL SQUARE, BOX 792, FORT DAVIS, TX 79734-0008
(432) 426-3217
(432) 426-3084
Mailing address
PO BOX 792, 1 MEMORIAL SQUARE, FORT DAVIS, TX 79734-0008
(432) 426-3217
(432) 426-3084
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144621303
—
TX
Enumeration date
08/30/2007
Last updated
04/30/2015
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