Provider Demographics
NPI:1972203362
Name:PLUCHECK, LUKE STANLEY (MSN, APRN, CPNP-AC)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:STANLEY
Last Name:PLUCHECK
Suffix:
Gender:M
Credentials:MSN, APRN, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 MEDICAL DR STE 550
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3755
Mailing Address - Country:US
Mailing Address - Phone:210-575-7870
Mailing Address - Fax:210-575-6131
Practice Address - Street 1:4410 MEDICAL DR STE 550
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3755
Practice Address - Country:US
Practice Address - Phone:210-575-7870
Practice Address - Fax:210-575-6131
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX936274163WP0218X
TX1113743363LA2100X, 363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0218XNursing Service ProvidersRegistered NursePediatric Oncology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX936274OtherRN LICENSE NUMBER