MEDICARE: MR. JOHN PAUL LUFT M.DIV., BCC

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	305R00000X	Preferred Provider Organization
2	171W00000X	Contractor
3	172V00000X	Community Health Worker
4	251S00000X	Community/Behavioral Health Agency
5	171M00000X	Case Manager/Care Coordinator
6	261QF0050X	Non-Surgical Family Planning Clinic/Center
7	171400000X	Health & Wellness Coach
8	302R00000X	Health Maintenance Organization
9	171R00000X	Interpreter
10	251K00000X	Public Health or Welfare Agency
11	101YP1600X	Pastoral Counselor	XP5406	ME
12	101YP1600X	Pastoral Counselor
13	174H00000X	Health Educator
14	172V00000X	Community Health Worker	13422	TX

General Provider Information

NPI Number	:	1578097135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN PAUL LUFT M.DIV., BCC

Provider Business Mailing Address
First Line	:	3004 FARRELL LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-1526
Country	:	US
Telephone Number	:	210-287-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	3004 FARRELL LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-1526
Country	:	US
Telephone Number	:	210-287-6100
Fax Number	:

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

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	05/10/2026

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