Luna Medical Clinic PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LUNA MEDICAL CLINIC PLLC

Practice address

112 W Queen Isabella Blvd Ste C
Port Isabel, TX 78578-2970

Phone

(956) 524-0555

Fax

(956) 524-0405

NPI assigned

Oct 9, 2018

Organization subpart

No

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

Authorized official

Name

Hila Trevino

Title

Credentialing Specialist

Phone

(956) 524-0555

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Rural health clinic certification: CCN 673959

Legal name

LUNA MEDICAL CLINIC PLLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 22, 2021

Last certification

Apr 22, 2021

Ownership / control type

1B

Organization structure

LLCProprietary

Incorporated

Nov 15, 2018 in TX

Enrollment address

112 W Queen Isabella Blvd
Ste C
Port Isabel, TX 78578-2970

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Martha G Cano, MD

  • Family Medicine Physician
  • Weslaco, TX
  • NPI 1861651598

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

  CMS ownership
• Gregory A Luna, PA

  • Medical Physician Assistant
  • Port Isabel, TX
  • NPI 1184949976

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory A Luna, PA

  • Medical Physician Assistant
  • Port Isabel, TX
  • NPI 1184949976
  Medicare reassignment
• Amber Theresa Arellano

  • Nurse Practitioner
  • Port Isabel, TX
  • NPI 1326978958

  Family Medicine

  NPD (past)
• Martha G Cano, MD

  • Family Medicine Physician
  • Weslaco, TX
  • NPI 1861651598
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1043785736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W QUEEN ISABELLA BLVD STE C",
            "city": "PORT ISABEL",
            "state": "TX",
            "postal_code": "785782970",
            "telephone_number": "956-524-0555",
            "fax_number": "956-524-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W QUEEN ISABELLA BLVD STE C",
            "city": "PORT ISABEL",
            "state": "TX",
            "postal_code": "785782970",
            "telephone_number": "956-524-0555",
            "fax_number": "956-524-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNA MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-09",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "HILA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "956-524-0555"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laguna Madre Chiropractic, P.a.
• Laguna Madre Rehabilitation Center
• Laguna Madre Rehabilitation Center
• Elna Leal, R.PH.
• Lilyarden Lactation
• Gregory A Luna, PA
• Maria Luna
• Madre Bay Consulting and Psychological Services, PLLC
• Hugo Cesar Mata, PT, DPT
• Janis Mays, C.R.N.A.

• Family Medicine Physician in Port Isabel, TX
• Providers in Port Isabel, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.