Individual
LACY EDWARD HARVILLE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8300 FLOYD CURL DR # DRIVE4G, SAN ANTONIO, TX 78229-3931
(210) 450-0999
Mailing address
8300 FLOYD CURL DR # DRIVE4G, SAN ANTONIO, TX 78229-3931
(210) 450-0999
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
H1284
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
32471
OK
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
H1284
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198459
BCBS OF TENNESSEE
TN
05
—
200661790A
—
OK
05
—
3068323
—
TN
Enumeration date
11/30/2005
Last updated
04/25/2024
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