Search › Texas › 2086S0105X
Anceslo Idicula, MD
NPI 1528446572 · on the registry since 2015 · sole proprietor
Practice
- Address
- 3601 4th St # Ms 8312
Lubbock, TX 79430 - Phone
- (806) 743-2373
- Fax
- (806) 743-4354
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 2086S0105X
2086S0105X
- Also registered as
- 208600000X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-09-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas