Provider Demographics
NPI:1659610970
Name:LUNA, GRACE
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5712 ANGEL DR
Mailing Address - Street 2:
Mailing Address - City:DEL VALLE
Mailing Address - State:TX
Mailing Address - Zip Code:78617-3665
Mailing Address - Country:US
Mailing Address - Phone:512-999-1472
Mailing Address - Fax:
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:BLDG. #2-300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-836-5665
Practice Address - Fax:512-997-9092
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information