Individual
JULIE LEE LUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, C-PNP
Contact information
Practice address
4410 MEDICAL DR STE 550, SAN ANTONIO, TX 78229-3755
(210) 575-2222
(210) 575-6131
Mailing address
4410 MEDICAL DR STE 550, SAN ANTONIO, TX 78229-3755
(210) 575-2222
(210) 575-6131
Taxonomy
Speciality
Code
Description
License number
State
163WP0218X
Pediatric Oncology Registered Nurse
256206
TX
363L00000X
Nurse Practitioner
Primary
256206
TX
363LP0200X
Pediatric Nurse Practitioner
256206
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193386307
MEDICAID - CSHCN
TX
05
—
193386309
—
TX
01
—
8CC920
BCBS
TX
Enumeration date
08/27/2007
Last updated
08/06/2019
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