Provider Demographics
NPI:1578958393
Name:OZUNA, LUIS PAGIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:PAGIEL
Last Name:OZUNA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 S GULPH RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3121
Mailing Address - Country:US
Mailing Address - Phone:956-631-0393
Mailing Address - Fax:956-682-4689
Practice Address - Street 1:1801 S 5TH ST STE 120
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-2919
Practice Address - Country:US
Practice Address - Phone:956-631-0393
Practice Address - Fax:956-682-4689
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2944208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4302770-02Medicaid
TX1U1226OtherPTAN
TX4302770-01Medicaid