Most Relevant Information
Provider Data
| NPI Number: | 1003435785 |
| Provider Name: | LUCA LACKORE PAC |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/13/2020 |
| Last Updated: | 04/13/2020 |
Provider Practice Location
4401 BOOTH CALLOWAY RD
NORTH RICHLAND HILLS
TX
761807371
Practice Location Phone/Fax
| Phone: | 8172551000 |
| Fax: |
Provider Mailing Location
5732 CARUTH BLVD
DALLAS
TX
752093534
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |