| Luna Medical Clinic Pllc | |
|
112 W Queen Isabella Ste C Port Isabel TX 78578-2970 | |
| (956) 821-0276 | |
| (956) 626-1511 |
| Full Name | Luna Medical Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 112 W Queen Isabella Ste C, Port Isabel, Texas |
| Authorized Official Name and Position | Hila Trevino (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9568210276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luna Medical Clinic Pllc 134 Chachalaca San Benito TX 78586-7962 Ph: (956) 821-0276 | Luna Medical Clinic Pllc 112 W Queen Isabella Ste C Port Isabel TX 78578-2970 Ph: (956) 821-0276 |
| NPI Number | 1043785736 |
|---|---|
| Provider Enumeration Date | 10/09/2018 |
| Last Update Date | 11/20/2018 |
| Medicare PECOS PAC ID | 8224379201 |
|---|---|
| Medicare Enrollment ID | O20190402000581 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043785736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
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