Anderson, Lucas Michal

Anderson, Lucas Michal is an sole proprietor health care provider with primary practice located at 6317 N Park Dr , Watauga TX 76148-1321. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Anderson, Lucas Michal can be contacted via phone (707) 738-0510.

Contact Information

Primary practice address
6317 N Park Dr Watauga TX 76148-1321
Phone: (707) 738-0510
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 52540 California
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA1668 Nevada
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA14846 Texas

Profile Details

NPI number 1396121646
LBN Legal business name Anderson, Lucas Michal
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2015
Last updated Nov 13th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396121646 NPPES
Nevada MEDICAID LA1225
Nevada MEDICAID 1396121646

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