Provider Demographics
NPI:1629259700
Name:LUCAS, SHARON K
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:K
Last Name:LUCAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:K
Other - Last Name:LUCAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SHARON STEWART
Mailing Address - Street 1:8510 PARK LN APT 204
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-6388
Mailing Address - Country:US
Mailing Address - Phone:972-804-3183
Mailing Address - Fax:
Practice Address - Street 1:8510 PARK LN APT 204
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-6388
Practice Address - Country:US
Practice Address - Phone:972-804-3183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-17
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK79159819251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health