Healthcare Provider Details

I. General information

NPI: 1083713085
Provider Name (Legal Business Name): THOMAS S LOFTUS MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PARK BEND DR BLDG. 2, STE. 202
AUSTIN TX
78758-5387
US

IV. Provider business mailing address

2200 PARK BEND DR BLDG. 2, STE. 202
AUSTIN TX
78758-5387
US

V. Phone/Fax

Practice location:
  • Phone: 512-836-0900
  • Fax: 512-836-0902
Mailing address:
  • Phone: 512-836-0900
  • Fax: 512-836-0902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS STUART LOFTUS
Title or Position: OWNER
Credential: M.D.
Phone: 512-836-0900