Healthcare Provider Details

I. General information

NPI: 1316163900
Provider Name (Legal Business Name): SHELLEY D LOOMSTEIN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5655 W SPRING CREEK PKWY SUITE 200
PLANO TX
75024-4236
US

IV. Provider business mailing address

5655 W SPRING CREEK PKWY SUITE 200
PLANO TX
75024-4236
US

V. Phone/Fax

Practice location:
  • Phone: 972-599-9600
  • Fax: 972-599-9696
Mailing address:
  • Phone: 972-599-9600
  • Fax: 972-599-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA03462
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: