Cecelia Mariko Luda, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD24719 Issued in OR

Practice address

221 3Rd St W
Jbsa Randolph, TX 78150-4800

Phone

(210) 565-0685

NPI assigned

Jul 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1629090212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 3RD ST W",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-565-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST W",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-565-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDA",
        "first_name": "CECELIA",
        "middle_name": "MARIKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD24719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Yie Lauvetz, PA
• Justin Sang-Gun Lee, DDS
• Edlyne Mae Else Liggayu, MSN, APRN, FNP-C
• Doria Living, PNP
• Kristyn Brooke Loggins, PHARMD RPH MS
• Deanne Villarreal Martinez, P.A.
• Joyce Debora Mason, RN
• Andrew Stuntz McCampbell, PA-C, DMSC
• Jacqueline Mills, JACQUELINE MILLS
• Milton R Miranda Rosa, MD

• Family Medicine Physician in Jbsa Randolph, TX
• Providers in Jbsa Randolph, 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 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.