Provider Demographics
NPI:1114923687
Name:LUI, PAUL THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:THOMAS
Last Name:LUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2149 E WARNER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3495
Mailing Address - Country:US
Mailing Address - Phone:480-610-6100
Mailing Address - Fax:480-610-6189
Practice Address - Street 1:2121 N BEVERLY AVE
Practice Address - Street 2:STE 105
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2154
Practice Address - Country:US
Practice Address - Phone:520-327-6265
Practice Address - Fax:520-327-9300
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ30151207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z6345OtherHEALTH NET INSURANCE
AZ69728701Medicaid
AZAZ0714210OtherBCBS OF ARIZONA
H58293Medicare UPIN
AZ69728701Medicaid