Healthcare Provider Details

I. General information

NPI: 1174313654
Provider Name (Legal Business Name): LA LUNA MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 W CAMPBELL RD STE 304
RICHARDSON TX
75080-3620
US

IV. Provider business mailing address

399 W CAMPBELL RD STE 304
RICHARDSON TX
75080-3620
US

V. Phone/Fax

Practice location:
  • Phone: 972-235-2304
  • Fax: 972-373-4040
Mailing address:
  • Phone: 972-235-2304
  • Fax: 972-373-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MAHMOUD SABHA
Title or Position: OWNER
Credential: MD
Phone: 972-235-2304