Provider Demographics
NPI:1871267757
Name:LUCIO, FELICITAS
Entity Type:Individual
Prefix:
First Name:FELICITAS
Middle Name:
Last Name:LUCIO
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 1:9955 BUFFALO SPEEDWAY APT 20207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1364
Mailing Address - Country:US
Mailing Address - Phone:346-256-5565
Mailing Address - Fax:
Practice Address - Street 1:12337 JONES RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4800
Practice Address - Country:US
Practice Address - Phone:903-345-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker