Individual
LORALYN H LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
710 FM 1960 RD, HOUSTON, TX 77090-3402
(281) 440-2543
Mailing address
710 FM 1960 RD, HOUSTON, TX 77090-3402
(281) 440-2543
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA04753
TX
363AM0700X
Medical Physician Assistant
Primary
PA04753
TX
Other
Enumeration date
06/26/2006
Last updated
10/03/2012
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