Provider Demographics
NPI:1740280692
Name:LUNA, RAYMOND J (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:J
Last Name:LUNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:219 EASTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-3342
Mailing Address - Country:US
Mailing Address - Phone:936-328-5213
Mailing Address - Fax:936-328-5216
Practice Address - Street 1:219 EASTWOOD ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-3342
Practice Address - Country:US
Practice Address - Phone:936-327-7147
Practice Address - Fax:936-327-6234
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG5318207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX76-0138230OtherFIN
TX080008150OtherRAILROAD MEDICARE
TX00G793OtherBLUECROSS BLUE SHIELD
TX136735104Medicaid
TX00G793Medicare PIN
TX76-0138230OtherFIN
TX136735104Medicaid