1083126783 NPI number — LISA LUCHSINGER PA

Table of content: LISA LUCHSINGER PA (NPI 1083126783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083126783 NPI number — LISA LUCHSINGER PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUCHSINGER
Provider First Name:
LISA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083126783
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 SUGAR CREEK CENTER BLVD STE 618
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77478-3540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-655-4141
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 SUGAR CREEK CENTER BLVD STE 618
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77478-3540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-655-4141
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X , with the licence number: PA13094 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 898604 . This is a "MEDICARE EMPLOYER PTAN - USA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8MD905 . This is a "BCBS - UNIVERSAL SURGICAL ASSISTANTS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1154026 . This is a "NCCPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8MD880 . This is a "BCBS - UNIVERSAL SURGICAL PARTNERS INC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 898609 . This is a "MEDICARE EMPLOYER PTAN - USP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8MD881 . This is a "BCBS - XCITE SURGICAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8MD923 . This is a "BCBS - BLUE STAR SURGICAL ASSISTANTS LLC" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: PA13094 . This is a "TEXAS MEDICAL BOARD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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