Individual provider Active NPI

Lydia A Luna, M.D., P. A.

  • Obstetrics & Gynecology Physician
  • Fort Worth, TX
National Provider Identifier
1043288590
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G1465 Issued in TX
Practice address
1307 8TH Ave
#602
Fort Worth, TX 76104-4143
Phone
(817) 877-1848
Fax
(817) 877-3716
NPI assigned
Mar 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G1465 TX Primary

Addresses

Primary practice location

1307 8TH Ave
#602
Fort Worth, TX 76104-4143

Mailing address

1307 8TH Ave
#602
Fort Worth, TX 76104-4143
Phone (817) 877-1848

Other identifiers 4

IdentifierTypeStateIssuer
G279OtherTXBCBS
00G279OtherTXMEDICARE ID #
2937634OtherTXCIGNA
4133080OtherTXAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
G1465TXMDObstetrics & Gynecology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1043288590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE",
            "address_2": "#602",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044143",
            "telephone_number": "817-877-1848",
            "fax_number": "817-877-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 8TH AVE",
            "address_2": "#602",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044143",
            "telephone_number": "817-877-1848",
            "fax_number": "817-877-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNA",
        "first_name": "LYDIA",
        "middle_name": "A",
        "credential": "M.D., P. A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "G1465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G279",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID #",
            "identifier": "00G279",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2937634",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4133080",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.