Individual
DR. JERRY LEE LUGGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
461 WESTPARK WAY, EULESS, TX 76040-3957
(817) 540-1755
(817) 685-7774
Mailing address
3061 W SOUTHLAKE BLVD, STE 130, SOUTHLAKE, TX 76092-0314
(817) 540-1755
(817) 685-7774
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
G2762
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P0007P724
—
TX
Enumeration date
06/29/2006
Last updated
02/02/2017
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