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NPI Code Detail

MEDICARE: LUMINA NEUROPSYCHOLOGICAL SERVICES, PLLC

MEDICARE: LUMINA NEUROPSYCHOLOGICAL SERVICES, PLLC
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
1251S00000XCommunity/Behavioral Health Agency
2103G00000XClinical Neuropsychologist

General Provider Information

NPI Number : 1710842323
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUMINA NEUROPSYCHOLOGICAL SERVICES, PLLC
Provider Business Mailing Address
First Line : 5900 BALCONES DR STE 100
Second Line :
City : AUSTIN
State : TX
Zip : 78731-4298
Country : US
Telephone Number : 512-271-9044
Fax Number : 512-271-9066
Provider Business Practice Location Address
First Line : 5900 BALCONES DR STE 27491
Second Line :
City : AUSTIN
State : TX
Zip : 78731-4298
Country : US
Telephone Number : 512-271-9044
Fax Number : 512-271-9066
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : DR. ALICIA MILAM
Credential : PH.D.
Telephone Number : 512-271-9044
Provider Enumeration Date : 12/17/2025
Last Update Date : 12/17/2025

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