MEDICARE: LOAJAH TINGLING PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1881425569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOAJAH TINGLING PA

Provider Business Mailing Address
First Line	:	7750 N MACARTHUR BLVD # 120-338
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 MAPLESHADE LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-5715
Country	:	US
Telephone Number	:	469-830-2350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2024
Last Update Date	:	08/13/2024

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Directions to “ LOAJAH TINGLING PA” Practice Location

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