Provider Demographics
NPI:1467774000
Name:LUEPKER, DUSTIN ROYSS (ATC)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:ROYSS
Last Name:LUEPKER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 PRESTWICK DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7280
Mailing Address - Country:US
Mailing Address - Phone:832-317-2093
Mailing Address - Fax:
Practice Address - Street 1:6125 PRESTWICK DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7280
Practice Address - Country:US
Practice Address - Phone:832-317-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT2452174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist