Provider Demographics
NPI:1164048526
Name:CLINICA SAN LUCAS FUQUA
Entity Type:Organization
Organization Name:CLINICA SAN LUCAS FUQUA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAROLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:713-254-2747
Mailing Address - Street 1:5615 TWIN RIVERS CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7133
Mailing Address - Country:US
Mailing Address - Phone:713-254-2747
Mailing Address - Fax:
Practice Address - Street 1:11019 FUQUA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-2510
Practice Address - Country:US
Practice Address - Phone:281-888-2804
Practice Address - Fax:281-888-2926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty