MEDICARE: DOMINGO LUNA

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	225200000X	Physical Therapy Assistant	2180142	TX

General Provider Information

NPI Number	:	1982563029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINGO LUNA

Provider Business Mailing Address
First Line	:	3646 WRIGHT ST
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78405
Country	:	US
Telephone Number	:	361-249-2794
Fax Number	:

Provider Business Practice Location Address
First Line	:	9929 S PADRE ISLAND DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78418-5105
Country	:	US
Telephone Number	:	361-657-0168
Fax Number	:

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

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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