LUNA MEDICAL CLINIC PLLC NPI 1043785736

NPI Information

  • NPI: 1043785736
  • Provider Name: LUNA MEDICAL CLINIC PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 45D2163984
  • Address: 112 W QUEEN ISABELLA STE C
    PORT ISABEL, TX
    ZIP 78578
  • Phone: (956) 821-0276

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NPI Details

LUNA MEDICAL CLINIC PLLC is a family medicine in Port Isabel, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LUNA MEDICAL CLINIC PLLC NPI is 1043785736. The provider is registered as an organization entity type.

The provider's business location address is:

112 W QUEEN ISABELLA STE C
PORT ISABEL, TX
ZIP 78578-970
Phone: (956) 821-0276
Fax: (956) 626-1511

The provider's authorized official is Hila Trevino .
The authorized official title is Credentialing Specialist and has the following contact phone number (956) 821-0276.

The CLIA number assigned to this NPI record is 45D2163984 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/9/2018 and was last updated on 11/20/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthNo
2207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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