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Individual

DR. LUCKY LUSTERIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-3536
Mailing address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-3536

Taxonomy

Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
02004069A
IN
208D00000X
General Practice Physician
Primary
02004069A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02004069A
MEDICAL LICENSE
IN
Enumeration date
02/21/2012
Last updated
10/10/2025
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