IndividualActive
Anceslo Idicula, MD
NPI 1528446572 · Surgery of the Hand (Surgery) Physician · Lubbock, TX
Provider details
- NPI number
- 1528446572
- Entity type
- Individual
- Primary specialty
- Surgery of the Hand (Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- BP10052704 (TX)
Practice location
3601 4th St # Ms 8312
Lubbock, TX 79430-0002
Phone: (806) 743-2373
Fax: (806) 743-4354
Mailing address
3601 4th St # Ms 8312
Lubbock, TX 79430-0002
Registry dates
- Enumerated
- 2015-05-11
- Last updated
- 2023-09-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.