Provider Demographics
NPI:1720076896
Name:LUNA, JOSEPH H (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:H
Last Name:LUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:J
Other - Middle Name:H
Other - Last Name:LUNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:M D, P A
Mailing Address - Street 1:94 BRIGGS ST
Mailing Address - Street 2:#300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1221
Mailing Address - Country:US
Mailing Address - Phone:210-928-7070
Mailing Address - Fax:210-928-9199
Practice Address - Street 1:94 BRIGGS ST
Practice Address - Street 2:#300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1221
Practice Address - Country:US
Practice Address - Phone:210-928-7070
Practice Address - Fax:210-928-9199
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4227207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00KT91OtherBCBSTX
TX135561209Medicaid
TX135561205Medicaid
TX135561205Medicaid
TX00212QMedicare PIN
TXTXB122610Medicare PIN
TX135561209Medicaid
TX135561210Medicare Oscar/Certification