Provider Demographics
NPI:1700970282
Name:LUCAS, MARSHALL B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:B
Last Name:LUCAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 NEW TRAILS DR STE 150
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4546
Mailing Address - Country:US
Mailing Address - Phone:281-367-1015
Mailing Address - Fax:281-367-1966
Practice Address - Street 1:8701 NEW TRAILS DR STE 150
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-4546
Practice Address - Country:US
Practice Address - Phone:281-367-1015
Practice Address - Fax:281-367-1966
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ00802084P0802X, 2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1366562225OtherFAMILY PSYCHIATRY OF THE WOODLANDS GROUP NPI - (OWNER)
TX1952993073OtherLUCAS PSYCHIATRIC ASSOCIATES - GROUP NPI FOR IND HOSP. BILLING- (OWNER)