Doctor Name: | GREGORY A LUNA |
NPI Number: | 1184949976 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | PA05710 |
Business Practice Address: | 1200 Highway 100 Ste 5 Port Isabel, TX - 785782450 |
Business Phone Number: | 9569436675 |
Business Fax Number: | |
Mailing Address: | 1200 Highway 100 Ste 5, PORT ISABEL |
State: | TX |
Postal Code: | 785782450 |
Phone Number: | 9569436675 |
Fax Number: | |
NPI Enumeration Date: | 04/05/2010 |
NPI Last Update Date: | 04/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA05710 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |