Basic Information
| Provider Information | |||||||||
| NPI: | 1831308048 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUNA | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 845347 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752845347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146458000 | ||||||||
| FaxNumber: | 2146457269 | ||||||||
| Practice Location | |||||||||
| Address1: | 5323 HARRY HINES BLVD. | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753907201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146458000 | ||||||||
| FaxNumber: | 2146457269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | P3034 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RA0002X | P3034 | TX | N | 207RC0000X | P3034 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RI0011X | P3034 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | BP1-0022663 | 01 | INSTITUTIONAL PERMIT | OTHER |