Provider Demographics
NPI:1447241955
Name:LUCCI, CHRISTOPHER PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PETER
Last Name:LUCCI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 LAKEVIEW DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-3552
Mailing Address - Country:US
Mailing Address - Phone:361-790-5155
Mailing Address - Fax:361-790-5156
Practice Address - Street 1:2600 LAKEVIEW DR
Practice Address - Street 2:SUITE D
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-3552
Practice Address - Country:US
Practice Address - Phone:361-790-5155
Practice Address - Fax:361-790-5156
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ15392083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EZ455OtherBCBS
TX401534ZNC8Medicare PIN
TX8EZ455OtherBCBS
TXF34794Medicare UPIN
TX1296279Medicaid