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General NPI Number Information
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NPI Number | 1356706642
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Entity Type | Organization
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Legal Business Name | LUMIN URGENT CARE, PLLC
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Dates
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Enumeration Date | 12/31/2015
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Last Update Date | 12/31/2015
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Provider Practice Location Address
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Address Line | 1005 STATE HIGHWAY 16 S
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City | GRAHAM
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State | TX
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Zip | 76450-3835
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Country | US
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Telephone | 972-573-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 N MACARTHUR BLVD #203
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City | IRVING
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State | TX
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Zip | 75038-6497
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Country | US
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Telephone | 972-573-7900
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Fax |
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Authorized Official
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Title or Position | COO
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Name | VICTOR WON
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Credential |
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Telephone | 972-573-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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