Provider Demographics
NPI:1356706642
Name:LUMIN URGENT CARE, PLLC
Entity type:Organization
Organization Name:LUMIN URGENT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:WON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-573-7900
Mailing Address - Street 1:4301 N MACARTHUR BLVD
Mailing Address - Street 2:#203
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6497
Mailing Address - Country:US
Mailing Address - Phone:972-573-7900
Mailing Address - Fax:
Practice Address - Street 1:1005 STATE HIGHWAY 16 S
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-3835
Practice Address - Country:US
Practice Address - Phone:972-573-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care