| Organization Name: | LUNA MEDICINE |
| NPI Number: | 1952683526 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN M. HAEST (PRESIDENT) |
| Mailing Address: | 1700 S Lamar Blvd Suite 240 Austin |
| State: | TX US |
| Postal Code: | 787048962 |
| Phone Number: | 5124738900 |
| Fax Number: | 5124729898 |
| NPI Enumeration Date: | 09/09/2011 |
| NPI Last Update Date: | 09/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | F9520 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |