Provider Demographics
NPI:1548493596
Name:LUNA, LISA M (CFO)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:LUNA
Suffix:
Gender:F
Credentials:CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 W I 30 STE 213
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-5728
Mailing Address - Country:US
Mailing Address - Phone:972-226-6496
Mailing Address - Fax:
Practice Address - Street 1:510 W I 30 STE 213
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-5728
Practice Address - Country:US
Practice Address - Phone:972-226-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter