| Organization Name: | LUMANDA PA |
| NPI Number: | 1609026475 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL ANDA NJOTU (PRESIDENT) |
| Mailing Address: | 4010 E Belknap St Haltom City |
| State: | TX US |
| Postal Code: | 761116609 |
| Phone Number: | 8178347161 |
| Fax Number: | 8178347104 |
| NPI Enumeration Date: | 09/29/2008 |
| NPI Last Update Date: | 09/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | PA01216 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |