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Individual

JOSE A LOERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 HARBORSIDE DR, GALVESTON, TX 77555-0001
(409) 772-2222
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
G2424
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
116873402
TX
01
380000373
RR PTAN
TX
Enumeration date
12/08/2006
Last updated
08/13/2008
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