Provider Demographics
NPI:1083882302
Name:LUNA, RICARDO JOSE (DC)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:JOSE
Last Name:LUNA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 ANGELITA DR STE 2
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78599-4790
Mailing Address - Country:US
Mailing Address - Phone:956-969-0158
Mailing Address - Fax:
Practice Address - Street 1:505 ANGELITA DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599-8693
Practice Address - Country:US
Practice Address - Phone:956-969-0158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB109753Medicare PIN