Provider Demographics
NPI:1932984622
Name:DE LUNA, ANDREA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:DE LUNA
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1000 HERITAGE CENTER CIR STE 122
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4463
Mailing Address - Country:US
Mailing Address - Phone:512-906-0168
Mailing Address - Fax:512-906-0158
Practice Address - Street 1:1000 HERITAGE CENTER CIR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4463
Practice Address - Country:US
Practice Address - Phone:512-906-0168
Practice Address - Fax:512-906-0158
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA17119363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant