Active NPI
Henry Luckett, M.D.
- Obstetrics & Gynecology Physician
- Tyler, TX
National Provider Identifier
1871648006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- E6130
- Practice address
- 700 Olympic Plaza Cir Ste 503
Tyler, TX 75701-1952 - Phone
- (903) 595-2211
- Fax
- (903) 595-1397
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | E6130 | TX | Primary |
Addresses
Primary practice location
700 Olympic Plaza Cir Ste 503
Tyler, TX 75701-1952
Mailing address
700 Olympic Plaza Cir Ste 503
Tyler, TX 75701-1952
Phone (903) 595-2211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E6130 | TX | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1871648006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 OLYMPIC PLAZA CIR STE 503",
"city": "TYLER",
"state": "TX",
"postal_code": "757011952",
"telephone_number": "903-595-2211",
"fax_number": "903-595-1397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 OLYMPIC PLAZA CIR STE 503",
"city": "TYLER",
"state": "TX",
"postal_code": "757011952",
"telephone_number": "903-595-2211",
"fax_number": "903-595-1397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCKETT",
"first_name": "HENRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "TX",
"license": "E6130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.