Healthcare Provider Details

I. General information

NPI: 1548539638
Provider Name (Legal Business Name): LUMIN HEALTH PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N MACARTHUR BLVD
IRVING TX
75038-6497
US

IV. Provider business mailing address

4301 N. MACARTHUR BLVD., SUITE 101
IRVING TX
75038
US

V. Phone/Fax

Practice location:
  • Phone: 972-255-5588
  • Fax: 972-255-6688
Mailing address:
  • Phone: 972-225-5588
  • Fax: 972-225-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS S WON
Title or Position: OWNER
Credential: MD
Phone: 972-255-5588