Provider Demographics
NPI:1376602342
Name:LUNA, VALENTINO PINEDA JR
Entity Type:Individual
Prefix:MR
First Name:VALENTINO
Middle Name:PINEDA
Last Name:LUNA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S IH 35 STE 125
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5707
Mailing Address - Country:US
Mailing Address - Phone:512-462-0001
Mailing Address - Fax:512-462-1926
Practice Address - Street 1:2800 S IH 35 STE 125
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5707
Practice Address - Country:US
Practice Address - Phone:512-462-0001
Practice Address - Fax:512-462-1926
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093573601Medicaid
TX093573601Medicaid