Provider Demographics
NPI:1023209558
Name:LUCAS HANEY, O.D., P.A.
Entity Type:Organization
Organization Name:LUCAS HANEY, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:806-486-1152
Mailing Address - Street 1:10701 MONTGOMERY BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3800
Mailing Address - Country:US
Mailing Address - Phone:505-828-0828
Mailing Address - Fax:
Practice Address - Street 1:2100 PERRYTON PKWY
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-3524
Practice Address - Country:US
Practice Address - Phone:806-486-1152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7065TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty