Healthcare Provider Details
I. General information
NPI: 1265653430
Provider Name (Legal Business Name): LOUGHRAN MEDICAL ARTS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3635 SHORE SHADOWS DR
CROSBY TX
77532-7220
US
IV. Provider business mailing address
3635 SHORE SHADOWS DR
CROSBY TX
77532-7220
US
V. Phone/Fax
- Phone: 765-318-0611
- Fax: 281-462-1960
- Phone: 765-318-0611
- Fax: 281-462-1960
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | M2382 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
JAMES
PATRICK
LOUGHRAN
Title or Position: OWNER PRESIDENT
Credential: M.D.
Phone: 765-318-0611