Healthcare Provider Details

I. General information

NPI: 1720875644
Provider Name (Legal Business Name): ANA ISABEL LOERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N WASHINGTON AVE STE 2700
DALLAS TX
75246-1735
US

IV. Provider business mailing address

7106 WATERBURY DR
ROWLETT TX
75089-3956
US

V. Phone/Fax

Practice location:
  • Phone: 214-975-3937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1195181
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: