Provider Demographics
NPI:1568088748
Name:LUCAS, HEATHER MACDONALD (MS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MACDONALD
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:GRACE
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2929 SUNNYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-5356
Mailing Address - Country:US
Mailing Address - Phone:214-538-4384
Mailing Address - Fax:
Practice Address - Street 1:620 S FLEISHEL AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2041
Practice Address - Country:US
Practice Address - Phone:903-606-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS