Provider Demographics
NPI:1629704507
Name:LUCE, LE-DRA
Entity Type:Individual
Prefix:
First Name:LE-DRA
Middle Name:
Last Name:LUCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9387 FM 1960 BYPASS RD W APT 9206
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4487
Mailing Address - Country:US
Mailing Address - Phone:662-571-5634
Mailing Address - Fax:
Practice Address - Street 1:9387 FM 1960 BYPASS RD W APT 9206
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4487
Practice Address - Country:US
Practice Address - Phone:662-571-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech