Provider Demographics
NPI:1851907885
Name:HARRISON LUKE, PLLC
Entity Type:Organization
Organization Name:HARRISON LUKE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRISON
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:409-866-2843
Mailing Address - Street 1:2425 ASHLEY ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1332
Mailing Address - Country:US
Mailing Address - Phone:903-738-3654
Mailing Address - Fax:
Practice Address - Street 1:8105 GLADYS AVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3161
Practice Address - Country:US
Practice Address - Phone:409-866-2843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental