Provider Demographics
NPI:1093224644
Name:LUNA, VICTOR S IV (PT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:S
Last Name:LUNA
Suffix:IV
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18626 HARDY OAK BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4228
Mailing Address - Country:US
Mailing Address - Phone:210-293-2922
Mailing Address - Fax:210-293-3901
Practice Address - Street 1:9150 HUEBNER RD STE 290
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240
Practice Address - Country:US
Practice Address - Phone:210-615-3566
Practice Address - Fax:210-293-3937
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1294400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist