Individual
LUCAS JACOMIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
302 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0200
(512) 509-0366
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L1081
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154466001
—
AR
05
—
165720701
—
TX
Enumeration date
07/21/2005
Last updated
09/18/2013
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