Healthcare Provider Details

I. General information

NPI: 1003047325
Provider Name (Legal Business Name): LANE D LOOKA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15217 S PADRE ISLAND DR STE 210E
CORPUS CHRISTI TX
78418-6196
US

IV. Provider business mailing address

15217 S PADRE ISLAND DR STE 210E
CORPUS CHRISTI TX
78418-6196
US

V. Phone/Fax

Practice location:
  • Phone: 361-281-3294
  • Fax: 361-229-3271
Mailing address:
  • Phone: 361-281-3294
  • Fax: 361-229-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number165719
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number651431
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPN.0010074-NP
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 10074
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0010074-NP
License Number StateCO
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1087481
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: