Provider Demographics
NPI:1275766891
Name:LOUMOS LLC
Entity Type:Organization
Organization Name:LOUMOS LLC
Other - Org Name:LOUMOS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOWOKERE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:832-445-7758
Mailing Address - Street 1:40 FM 1960 RD W # 245
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3530
Mailing Address - Country:US
Mailing Address - Phone:281-364-3525
Mailing Address - Fax:
Practice Address - Street 1:7333 CLAREWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4405
Practice Address - Country:US
Practice Address - Phone:832-445-7758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-30
Last Update Date:2009-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service