DR. LUCKY LUSTERIO


Address: 221 3rd St. W, Randolph Afb, TX 78150
Phone: 2106520201

DR. LUCKY LUSTERIO (NPI# 1609149681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609149681
Entity Type Individual
Full Name DR. LUCKY LUSTERIO
Credential D.O.
Practice Address 221 3rd St. W
Randolph Afb
TX 78150
Practice Telephone 2106520201
Mailing Telephone 2106520201
Enumeration Date 2012-02-21
Last Update Date 2020-02-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2083A0100X Preventive Medicine
Specialization: Aerospace Medicine
02004069A IN Allopathic & Osteopathic Physicians
N 208D00000X General Practice 02004069A IN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IN MEDICAL LICENSE 02004069A 01

Office Location

Street Address 221 3RD ST. W
City RANDOLPH AFB
State TX
Zip Code 78150

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770045833 Erica Renae Guevara Physician Assistant 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 2019-04-05
1457803868 Emily Newman Dietitian, Registered 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 2016-11-02
1922411677 Amber Drewer Military Health Care Provider 3rd Street West Building 1040, Randolph Afb, TX 78150 2014-06-10
1144652975 Josephine Kimberly Olsen Family Medicine 359 Mdos/mdg, Randolph Afb, TX 78150 2013-08-02
1417120569 Joni Hodgson General Practice 221 3rd Street West, Jbsa Randolph, TX 78150 2008-04-09
1710095724 Katherine Justen Adamson Physician Assistant 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 2006-08-29
1811950090 Lidia Stana Ilcus Internal Medicine 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 2006-04-10
1013970672 David Hamilton Social Worker 12mdos/sgohf, Randolph Afb, TX 78150 2006-04-06
1962465526 Robert Allan Briggs Physical Therapist Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 2006-04-06
1982685566 John Yoonsik Oh Internal Medicine 221 Third St, Bldg 1040, Attn: 359 Mdg/sghq, Jbsa Randolph, TX 78150 2005-11-09
Find all providers in zip 78150

Taxonomy Information

Taxonomy Code 2083A0100X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Aerospace Medicine

Taxonomy Definition

Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1528488558 Maxwell Dickey Preventive Medicine 221 3rd St W, Randolph Afb, TX 78150-4800 2014-04-17
1801114905 Joanna Marliss Funk Nelms Preventive Medicine 221 3rd St W, Randolph Afb, TX 78150-4800 2010-05-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1295267573 Quinn Dufurrena Preventive Medicine 301 University Blvd # 1110, Galveston, TX 77555-1110 2017-03-28
1760841423 Anant Shukla Preventive Medicine Mendoza Aviation Clinic (11335 Ssg Sims Blvd), El Paso, TX 79935 2016-02-23
1689069296 Darryl George Demaris Preventive Medicine Texas A&m Hsc Com S&w Hospital, 2401 S. 31st Street - Ms-01-w256, Temple, TX 76508-0001 2015-03-31
1639505951 Mark Richard Hannay Preventive Medicine 614 Mccain St Ste 310, Kingsville, TX 78363 2013-09-18
1407198823 David Chase Rogers Preventive Medicine 1100 Wilfod Hall Loop, Bldg. 4556, Lackland Afb, TX 78236-9908 2013-03-24
1326387291 Skin Institute Preventive Medicine 1901 Babcock Rd Ste 200, San Antonio, TX 78229-4545 2013-02-12
1710221742 Conrad Ivan Dalton Preventive Medicine 98 S. Shawnee Ridge Circle, The Woodlands, TX 77382-2555 2012-11-15
1164766358 Guillermo J. Salazar Preventive Medicine 2601 Meacham Blvd, Faa, Asw-300, Fort Worth, TX 76137-4204 2012-11-12
1205139367 Kenneth Edward Cottle Preventive Medicine 148 S Bay Dr, Bullard, TX 75757-8929 2010-12-13
1245498922 Richard Harris Stoller Preventive Medicine 13714 Cape Blf, San Antonio, TX 78216-1605 2008-05-29
Find all providers with the same taxonomy

Competitor

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City RANDOLPH AFB
Zip Code 78150

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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