Organization Active NPI

Luminance Health and Beauty PLLC

  • Family Medicine Physician
  • Missouri City, TX
National Provider Identifier
1750917209
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LUMINANCE HEALTH AND BEAUTY PLLC
Practice address
4502 Riverstone Blvd Ste 605
Missouri City, TX 77459-5205
Phone
(281) 942-6226
NPI assigned
Mar 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Authorized official

Name
Chinh Quoc Pham, MDNPI 1619148715
Title
Owner
Phone
(281) 942-6226

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4502 Riverstone Blvd Ste 605
Missouri City, TX 77459-5205

Mailing address

7715 Tiburon TRL
Sugar Land, TX 77479-6157
Phone (281) 942-6226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200916001477 TX Part B Supplier - Clinic/Group Practice 0244658680 Receives reassigned benefits from 1 practitioner
Practice locations: Missouri City, TX

National Provider Directory

National Provider Directory

Locations

4502 Riverstone Blvd
Ste 605
Missouri City, TX 77459
Phone (281) 942-6226

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1750917209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 TIBURON TRL",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796157",
            "telephone_number": "281-942-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 RIVERSTONE BLVD STE 605",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774595205",
            "telephone_number": "281-942-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINANCE HEALTH AND BEAUTY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "CHINH",
        "authorized_official_middle_name": "QUOC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-942-6226",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.