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Joseph G Lugo
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NPI Number Detailed Information
Provider Information:
| Name: | Joseph G Lugo |
| Gender: | M |
| Provider License Number If Given: | 2002012685 |
NPI Information:
| NPI: | 1770582223 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 7/29/2016 |
Provider Business Mailing Address:
| Address: | PO BOX 122152 DEPT 2152 Dallas, TX 75312 |
| Phone Number: | 3374943278 |
| Fax Number: | 3374946969 |
Provider Business Practice Location Address:
| Address: | 222 S WOODS MILL RD SUITE 550-N Chesterfield, MO 63017 |
| Phone Number: | 3144343049 |
| Fax Number: | 3142056916 |
Provider Taxonomy:
| Primary: | 208G00000X |
| Secondary (if any): | |
| State: | MO |
