Provider Demographics
NPI:1568579530
Name:LEYKUM, LUCI (MD)
Entity Type:Individual
Prefix:
First Name:LUCI
Middle Name:
Last Name:LEYKUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DRIVE, RM 5.069R
Mailing Address - Street 2:UTHSCSA, DEPT. OF MEDICINE
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-358-4000
Mailing Address - Fax:210-257-1428
Practice Address - Street 1:911 W 38TH ST STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-9918
Practice Address - Country:US
Practice Address - Phone:855-481-8375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9780207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170256503OtherCSHCN
TX170256502Medicaid
TX170256503OtherCSHCN