Provider Demographics
NPI:1053381418
Name:ARCE, LUIS R (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:R
Last Name:ARCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6450
Mailing Address - Fax:
Practice Address - Street 1:619 S FLEISHEL AVE
Practice Address - Street 2:STE 327
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2004
Practice Address - Country:US
Practice Address - Phone:903-510-1173
Practice Address - Fax:903-525-1312
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2250207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7149558OtherAENTA
TX75-0818167-015OtherTRICARE
TX176818601Medicaid
TX8ED744OtherBCBS
TX8S3313OtherBCBS
TXP01303109OtherRAIL ROAD
TX176818602Medicaid
TXTAX ID AND 012OtherTRICARE
TX136917OtherSUPERIOR/CHIPS
TX176818603Medicaid
TX8ED744OtherBCBS
TX176818603Medicaid
TX176818601Medicaid
TX75-0818167-015OtherTRICARE
TXTAX ID AND 012OtherTRICARE