Healthcare Provider Details

I. General information

NPI: 1376842674
Provider Name (Legal Business Name): ISABEL ALICIA LOFTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 FM 359 RD STE H
RICHMOND TX
77406-2023
US

IV. Provider business mailing address

9306 CAVALIER LN
ROSENBERG TX
77469-1790
US

V. Phone/Fax

Practice location:
  • Phone: 281-232-1900
  • Fax:
Mailing address:
  • Phone: 713-291-9850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number32328
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: