Basic Information
| Provider Information | |||||||||
| NPI: | 1548442890 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUTZKER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | WAYNE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3827 N 10TH ST STE 305 | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785011745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9568030748 | ||||||||
| FaxNumber: | 8056869676 | ||||||||
| Practice Location | |||||||||
| Address1: | 573 W PUTNAM AVE | ||||||||
| Address2: | |||||||||
| City: | PORTERVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932573270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597811812 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2007 | ||||||||
| LastUpdateDate: | 08/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | G24190 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.