DR. LUCKY LUSTERIO D.O. NPI 1609149681

NPI Information

  • NPI: 1609149681
  • Provider Name: DR. LUCKY LUSTERIO, D.O.
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1100 WILFORD HALL LOOP
    JBSA LACKLAND, TX
    ZIP 78236
  • Phone: (210) 292-3536

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NPI Details

DR. Lucky Lusterio, D.O. is a general practice in Jbsa Lackland, TX. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Lucky Lusterio, D.O. NPI is 1609149681. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1100 WILFORD HALL LOOP
JBSA LACKLAND, TX
ZIP 78236-638
Phone: (210) 292-3536

The NPI 1609149681 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/21/2012 and was last updated on 10/10/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12083A0100XPreventive MedicineAerospace Medicine02004069AINDIANANo
2208D00000XGeneral Practice02004069AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
102004069AOTHERINDIANAMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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