Provider Demographics
NPI:1801659750
Name:LUMINAR LOOM LLC
Entity type:Organization
Organization Name:LUMINAR LOOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:RAMZAN
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-770-7484
Mailing Address - Street 1:310 WYNDALE DR
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4325
Mailing Address - Country:US
Mailing Address - Phone:469-770-7484
Mailing Address - Fax:
Practice Address - Street 1:310 WYNDALE DR
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-4325
Practice Address - Country:US
Practice Address - Phone:469-770-7484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies