Healthcare Provider Details

I. General information

NPI: 1710842323
Provider Name (Legal Business Name): LUMINA NEUROPSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BALCONES DR STE 27491
AUSTIN TX
78731-4298
US

IV. Provider business mailing address

5900 BALCONES DR STE 100
AUSTIN TX
78731-4298
US

V. Phone/Fax

Practice location:
  • Phone: 512-271-9044
  • Fax: 512-271-9066
Mailing address:
  • Phone: 512-271-9044
  • Fax: 512-271-9066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALICIA MILAM
Title or Position: CLINICAL DIRECTOR
Credential: PH.D.
Phone: 512-271-9044