Provider Demographics
NPI:1972202174
Name:LUERA, DAISY
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:LUERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 S PADRE ISLAND DR APT 1707
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-5245
Mailing Address - Country:US
Mailing Address - Phone:817-291-3517
Mailing Address - Fax:
Practice Address - Street 1:8033 S PADRE ISLAND DR APT 1707
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-5245
Practice Address - Country:US
Practice Address - Phone:817-291-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer