Organization
LUMINOUS MED SPA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN DOUGLAS FRADKIN MD (MANAGING MEMBER)
(214) 676-1250
Entity
Organization
Contact information
Practice address
2412 PRESTON RD STE 160, PLANO, TX 75093-2304
(214) 676-1250
Mailing address
2140 E SOUTHLAKE BLVD STE L-229, SOUTHLAKE, TX 76092-6516
(214) 676-1250
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
07/03/2024
Last updated
07/03/2024
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