Provider Demographics
NPI:1750917209
Name:LUMINANCE HEALTH AND BEAUTY PLLC
Entity type:Organization
Organization Name:LUMINANCE HEALTH AND BEAUTY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHINH
Authorized Official - Middle Name:QUOC
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-942-6226
Mailing Address - Street 1:7715 TIBURON TRL
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6157
Mailing Address - Country:US
Mailing Address - Phone:281-942-6226
Mailing Address - Fax:
Practice Address - Street 1:4502 RIVERSTONE BLVD STE 605
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5205
Practice Address - Country:US
Practice Address - Phone:281-942-6226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty