Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M1891 | TX |
N | 111NI0900X | Internist | M1891 | TX |
Y | 207RR0500X | Rheumatology | M1891 | TX |
NPI | 1023212990 |
---|---|
Provider Name | Dr. Awilda Michelle Luciano |
First Address | Denton, TX 76201 |
Second Address | Denton, TX 76201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 26/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
197184801 | (05) | TX |
OTH018 | (02) | TX |