Organization
LUZ DE LUNA MEDICAL CENTER, PLLC
Active
Other names
MI LUZ DE LUNA
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR R QUEZADA JR. M.D. (OWNER/PRESIDENT)
(915) 875-1200
Entity
Organization
Contact information
Practice address
10657 VISTA DEL SOL DR STE E, EL PASO, TX 79935-4504
(915) 875-1200
(915) 629-7719
Mailing address
10657 VISTA DEL SOL DR STE E, EL PASO, TX 79935-4504
(915) 875-1200
(915) 629-7719
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2835480-01
—
TX
01
—
2835480-02
THSTEPS MEDICAID
TX
05
—
2835480-03
—
TX
Enumeration date
10/29/2010
Last updated
06/13/2013
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