Individual provider Active NPI

Evelene Rene Luna, NP

  • Family Nurse Practitioner
  • Red Oak, TX
National Provider Identifier
1982363834
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1046953 Issued in TX
Practice address
104 Plaza Dr
Red Oak, TX 75154-3981
Phone
(972) 515-8700
Fax
(214) 764-8588
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1046953 TX Primary

Addresses

Primary practice location

104 Plaza Dr
Red Oak, TX 75154-3981

Mailing address

104 Plaza Dr
Red Oak, TX 75154-3981
Phone (972) 515-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220121002467 TX Practitioner - Nurse Practitioner 4587056668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1982363834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PLAZA DR",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751543981",
            "telephone_number": "972-515-8700",
            "fax_number": "214-764-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PLAZA DR",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751543981",
            "telephone_number": "972-515-8700",
            "fax_number": "214-764-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNA",
        "first_name": "EVELENE",
        "middle_name": "RENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1046953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Oak, TX

Sources for this page

Verify at the official NPI Registry.