Provider Demographics
NPI:1568411411
Name:LUCAS, THOMAS WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:LUCAS
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 1:3500 OAKLAWN AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4349
Mailing Address - Country:US
Mailing Address - Phone:972-709-1961
Mailing Address - Fax:972-283-1689
Practice Address - Street 1:3500 OAKLAWN AVE
Practice Address - Street 2:STE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4349
Practice Address - Country:US
Practice Address - Phone:972-709-1961
Practice Address - Fax:972-283-1689
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH74592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86X590OtherBCBS
TX084786501Medicaid
TX260026019OtherMEDICARE RAILROAD
TXB98838Medicare UPIN
86X590Medicare ID - Type Unspecified
TX084786501Medicaid