Luminous Med Spa PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

LUMINOUS MED SPA PLLC

Practice address

2412 Preston Rd Ste 160
Plano, TX 75093-2304

Phone

(214) 676-1250

NPI assigned

Jul 3, 2024

Organization subpart

No

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

Authorized official

Name

Kevin Douglas Fradkin, MDNPI 1972603934

Title

Managing Member

Phone

(214) 676-1250

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Kevin D Fradkin, M.D.

  • Surgery Physician
  • Houston, TX
  • NPI 1972603934
  NPD Authorized official

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1821834342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 E SOUTHLAKE BLVD STE L-229",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926516",
            "telephone_number": "214-676-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 PRESTON RD STE 160",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750932304",
            "telephone_number": "214-676-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINOUS MED SPA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "FRADKIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "214-676-1250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irin Rachel Luke
• Christy Lukose, MD
• Lumiere Psychiatry PLLC
• Lumin Health Physician Group PA
• Luminary Nutrition LLC
• Luna Bella Counseling, PLLC
• John Luna
• Karri Luna, LCSW
• Leslie Luna, LMT
• Earl R Lund, M.D.

• Surgery Physician in Plano, TX
• Providers in Plano, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.