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NPI Code Detail

MEDICARE: PRESTON LOOPER MS

MEDICARE:   PRESTON  LOOPER  MS
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
1101YP2500XProfessional Counselor10304TX
2101YP2500XProfessional Counselor2072CO

General Provider Information

NPI Number : 1912031360
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRESTON LOOPER MS
Provider Business Mailing Address
First Line : 2600 N STEMMONS FWY
Second Line : SUITE 182
City : DALLAS
State : TX
Zip : 75207-2113
Country : US
Telephone Number : 888-956-2226
Fax Number :
Provider Business Practice Location Address
First Line : 2600 N STEMMONS FWY
Second Line : SUITE 182
City : DALLAS
State : TX
Zip : 75207-2113
Country : US
Telephone Number : 888-956-2226
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 11/16/2011

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Directions to “ PRESTON LOOPER MS” Practice Location

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