Provider Demographics
NPI:1508182932
Name:MCBRIDE, LUKE BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:BENJAMIN
Last Name:MCBRIDE
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 1:865 DESHONG DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-9313
Mailing Address - Country:US
Mailing Address - Phone:903-737-1111
Mailing Address - Fax:
Practice Address - Street 1:1001 W EAGLE DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3745
Practice Address - Country:US
Practice Address - Phone:940-683-5287
Practice Address - Fax:940-683-4382
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0914207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXP0914Medicare PIN