Individual provider Active NPI

Lucio I Mares, PA

  • Physician Assistant
  • Eagle Pass, TX
National Provider Identifier
1972729507
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00646 Issued in TX
Practice address
144 Falcon Blvd Apt 2
Eagle Pass, TX 78852-5861
Phone
(830) 513-1123
Fax
(830) 773-2981
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00646 TX Primary

Addresses

Primary practice location

144 Falcon Blvd Apt 2
Eagle Pass, TX 78852-5861

Mailing address

2203 Del Rio Blvd Ste D
Eagle Pass, TX 78852-3360
Phone (830) 776-7324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100607000236 TX Practitioner - Physician Assistant 2961532650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jorge a Barboza-Sosa MD PAGroup PAC ID 7416042536, 2 clinicians

Practice addresses (Care Compare)

2203 Del Rio Blvd
Suite D
Eagle Pass, TX 78852-3360
Phone (830) 776-7324

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maverick County Medical Family Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lucio.marez.1@18663.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1972729507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 DEL RIO BLVD STE D",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788523360",
            "telephone_number": "830-776-7324",
            "fax_number": "830-776-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 FALCON BLVD APT 2",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788525861",
            "telephone_number": "830-513-1123",
            "fax_number": "830-773-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARES",
        "first_name": "LUCIO",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

Verify at the official NPI Registry.