Provider Demographics
NPI:1669536363
Name:LUNA, LEONARD (DC)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:LUNA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14731 BELTERRAZA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6760
Mailing Address - Country:US
Mailing Address - Phone:713-391-0269
Mailing Address - Fax:713-589-8844
Practice Address - Street 1:11211 KATY FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2106
Practice Address - Country:US
Practice Address - Phone:713-230-8425
Practice Address - Fax:713-589-8844
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011291111N00000X
TX11271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01811930Medicaid
NY02646Medicare ID - Type Unspecified