Provider Demographics
NPI:1174576714
Name:LECUSAY, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LECUSAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:864 CENTRAL BLVD
Mailing Address - Street 2:SUITE 2700
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7551
Mailing Address - Country:US
Mailing Address - Phone:956-544-6900
Mailing Address - Fax:956-544-6905
Practice Address - Street 1:864 CENTRAL BLVD
Practice Address - Street 2:SUITE 2700
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7551
Practice Address - Country:US
Practice Address - Phone:956-544-6900
Practice Address - Fax:956-544-6905
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL9777208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL9777OtherSTATE LICENSE
TX60136090OtherDPS
TXBL8934172OtherDEA