Individual
CHRISTINE LOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3310 LIVE OAK ST, COPC ADMINISTRATION, DALLAS, TX 75204-6153
(214) 266-1247
(214) 266-1246
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L4539
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155632602
—
TX
05
—
155632604
—
TX
05
—
155632605
—
TX
05
—
155632606
—
TX
05
—
155632607
—
TX
05
—
155632608
—
TX
05
—
155632609
—
TX
05
—
155632610
—
TX
05
—
155632612
—
TX
05
—
155632614
—
TX
05
—
155632615
—
TX
05
—
155632616
—
TX
05
—
155632617
—
TX
05
—
155632618
—
TX
05
—
155632619
—
TX
05
—
155632620
—
TX
05
—
155632621
—
TX
05
—
155632622
—
TX
05
—
155632623
—
TX
05
—
155632624
—
TX
05
—
155632625
—
TX
05
—
155632626
—
TX
01
—
8W8851
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/15/2005
Last updated
02/20/2013
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