Provider Demographics
NPI:1124189634
Name:LOOPER, STAN H (LPC)
Entity Type:Individual
Prefix:
First Name:STAN
Middle Name:H
Last Name:LOOPER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 FEAGAN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-7260
Mailing Address - Country:US
Mailing Address - Phone:713-705-4788
Mailing Address - Fax:
Practice Address - Street 1:6500 CHIMMEY ROCK
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5070
Practice Address - Country:US
Practice Address - Phone:713-222-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20159101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2478LCOtherBCBS ID NUMBER
TX179405902Medicaid
TX179405901Medicaid
TX179405903Medicaid