Provider Demographics
NPI:1013925130
Name:LU, DOUGLAS (DC, PT, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:DC, PT, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E QUINCY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1922
Mailing Address - Country:US
Mailing Address - Phone:210-229-7242
Mailing Address - Fax:210-227-5092
Practice Address - Street 1:303 E QUINCY ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1922
Practice Address - Country:US
Practice Address - Phone:210-229-7242
Practice Address - Fax:210-227-5092
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9318111N00000X
TX1169100225100000X
TXAP144579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist