Provider Demographics
NPI:1790565901
Name:LUNA, VICTORIA ALEXIS
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ALEXIS
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 1:3014 CLEARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3412
Mailing Address - Country:US
Mailing Address - Phone:210-872-7823
Mailing Address - Fax:
Practice Address - Street 1:3014 CLEARFIELD DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3412
Practice Address - Country:US
Practice Address - Phone:210-872-7823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management