Individual
LUZ A VENTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L4857
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044791401
—
TX
05
—
044791404
—
TX
05
—
044791405
—
TX
01
—
8BQ332
BCBS
TX
Enumeration date
10/26/2005
Last updated
10/12/2010
Update your record
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