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NPI Code Detail

MEDICARE: VICTOR EUGENE LOOS PH.D.

MEDICARE: VICTOR EUGENE LOOS PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist2-3466TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1180170OTHERTXVALUE OPTIONS
200K72HOTHERTXBCBS OF TX
310016996OTHERTXAMERIGROUP

General Provider Information

NPI Number : 1154353597
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR EUGENE LOOS PH.D.
Provider Business Mailing Address
First Line : 2524 NOTTINGHAM ST
Second Line :
City : HOUSTON
State : TX
Zip : 77005-1412
Country : US
Telephone Number : 713-526-4751
Fax Number : 713-526-4342
Provider Business Practice Location Address
First Line : 2524 NOTTINGHAM ST
Second Line :
City : HOUSTON
State : TX
Zip : 77005-1412
Country : US
Telephone Number : 713-526-4751
Fax Number : 713-526-4342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/09/2007

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Directions to “ VICTOR EUGENE LOOS PH.D.” Practice Location

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