MEDICARE: MR. HARRISON LUNA PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA01342	TX

General Provider Information

NPI Number	:	1386685238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HARRISON LUNA PA-C

Provider Business Mailing Address
First Line	:	4338 EMORY RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79922-1109
Country	:	US
Telephone Number	:	800-444-7009
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 N BEDELL AVE
Second Line	:	EMERGENCY DEPARTMENT
City	:	DEL RIO
State	:	TX
Zip	:	78840-4112
Country	:	US
Telephone Number	:	830-703-1702
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	07/09/2007

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