Provider Demographics
NPI:1821075664
Name:LOOSE, ISAAC ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:ARTHUR
Last Name:LOOSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5717 BALCONES DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4203
Mailing Address - Country:US
Mailing Address - Phone:512-327-7000
Mailing Address - Fax:512-314-1660
Practice Address - Street 1:5717 BALCONES DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-327-7000
Practice Address - Fax:512-314-1660
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4498207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2290235OtherAETNA HMO
TX100803902Medicaid
TX100803901Medicaid
TX87Y039Medicare PIN
TX2224465OtherBLUELINK
NY31667-018OtherDAVIS VISION
126274103OtherFIRST CARE
NY55343-008OtherDAVIS VISION
B24465Medicare UPIN
SC180033453Medicare PIN
TX10011898OtherAMERIGROUP
131469100OtherFIRST CARE
TX5098101OtherAETNA
TX80360SOtherBLUE CROSS BLUE SHIELD
TX80500KMedicare PIN
SC180034635Medicare PIN