Provider Demographics
NPI:1023127255
Name:LUNA, JOSEPH RENTERIA III (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RENTERIA
Last Name:LUNA
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1045 CENTRAL PKWY N
Mailing Address - Street 2:#200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5085
Mailing Address - Country:US
Mailing Address - Phone:210-536-9591
Mailing Address - Fax:904-425-2949
Practice Address - Street 1:12602 TOEPPERWEIN RD
Practice Address - Street 2:#100
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3269
Practice Address - Country:US
Practice Address - Phone:210-654-0030
Practice Address - Fax:855-278-4550
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2016-11-18
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Provider Licenses
StateLicense IDTaxonomies
TXJ9594207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG41125OtherUPIN #
TX113228407Medicaid
TX497365ZLM2Medicare PIN
TX8591K0Medicare ID - Type Unspecified