Healthcare Provider Details

I. General information

NPI: 1912274648
Provider Name (Legal Business Name): HEATHER KARINA LOYO PH.D., MBA, RMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 05/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S AUSTIN AVE BUILDING 2 SUITE 202
GEORGETOWN TX
78626-5637
US

IV. Provider business mailing address

501 S AUSTIN AVE BUILDING 2 SUITE 202
GEORGETOWN TX
78626-5637
US

V. Phone/Fax

Practice location:
  • Phone: 512-686-1107
  • Fax:
Mailing address:
  • Phone: 512-686-1107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT011711
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: