Provider Demographics
NPI:1508413204
Name:LUNA, ALESA (CPHT)
Entity Type:Individual
Prefix:MS
First Name:ALESA
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5135 PLAINS BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4515
Mailing Address - Country:US
Mailing Address - Phone:806-352-2708
Mailing Address - Fax:
Practice Address - Street 1:5135 PLAINS BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4515
Practice Address - Country:US
Practice Address - Phone:806-352-2708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician