Provider Demographics
NPI:1154569499
Name:LUNA, JOSE HUMBERTO
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:HUMBERTO
Last Name:LUNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10896 BUSINESS 83
Mailing Address - Street 2:
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559-4306
Mailing Address - Country:US
Mailing Address - Phone:956-797-0159
Mailing Address - Fax:956-797-3595
Practice Address - Street 1:10896 BUSINESS 83
Practice Address - Street 2:
Practice Address - City:LA FERIA
Practice Address - State:TX
Practice Address - Zip Code:78559-4306
Practice Address - Country:US
Practice Address - Phone:956-797-0159
Practice Address - Fax:956-797-3595
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-24
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0117283747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider