Provider Demographics
NPI:1619544004
Name:LUNA FAMILY MEDICAL, PLLC
Entity Type:Organization
Organization Name:LUNA FAMILY MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANAYANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-221-2218
Mailing Address - Street 1:PO BOX 2601
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-2601
Mailing Address - Country:US
Mailing Address - Phone:956-600-8199
Mailing Address - Fax:956-600-8301
Practice Address - Street 1:2605 W MILE 5 RD STE E5
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-0981
Practice Address - Country:US
Practice Address - Phone:956-600-8199
Practice Address - Fax:956-600-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-05
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty