Individual
RENE ANGEL LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10494 W THUNDERBIRD RD, STE102, SUN CITY, AZ 85351-6122
(623) 537-5600
(866) 939-2673
Mailing address
18444 N 25TH AVE, STE 310, PHOENIX, AZ 85023-1266
(623) 537-5600
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
19775
AZ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
19775
AZ
208VP0000X
Pain Medicine Physician
19775
AZ
208VP0014X
Interventional Pain Medicine Physician
19775
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013061
—
AZ
01
—
5550830001
MEDICARE NSC SCW
AZ
01
—
5550830003
MEDICARE NSC PEORIA
AZ
01
—
5550830004
MEDICARE NSC PV
AZ
01
—
5550830006
MEDICARE NSC ANTHEM
AZ
01
—
5550830007
MEDICARE NSC DV
AZ
01
—
5550830008
MEDICARE NSC SWV
AZ
01
—
5550830009
MEDICARE NSC AZ NORTH
AZ
01
—
5550830010
MEDICARE NSC GILBERT
AZ
01
—
P00363400
RR MEDICARE
AZ
Enumeration date
08/24/2005
Last updated
03/29/2024
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