Provider Demographics
NPI:1295036796
Name:J.SCOTT LUTHER, M.D., P.A
Entity Type:Organization
Organization Name:J.SCOTT LUTHER, M.D., P.A
Other - Org Name:PROGRAM PICANTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:J.SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:210-615-8070
Mailing Address - Street 1:4410 MEDICAL DR
Mailing Address - Street 2:SUITE240
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6306
Mailing Address - Country:US
Mailing Address - Phone:210-615-8070
Mailing Address - Fax:210-615-6645
Practice Address - Street 1:4410 MEDICAL DR
Practice Address - Street 2:SUITE 240
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6306
Practice Address - Country:US
Practice Address - Phone:210-615-8070
Practice Address - Fax:210-615-6645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099320603Medicaid
TX0077WKOtherBCBS
TXTXB119920Medicare PIN