Provider Demographics
NPI:1922253996
Name:LOFTIS, DANITA JOYCE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DANITA
Middle Name:JOYCE
Last Name:LOFTIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7910
Mailing Address - Country:US
Mailing Address - Phone:254-751-4002
Mailing Address - Fax:
Practice Address - Street 1:9229 LBJ FWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3405
Practice Address - Country:US
Practice Address - Phone:972-739-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant