Provider Demographics
NPI:1992027908
Name:LOESCH, JEFFREY SCOTT (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:LOESCH
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19245 DAVID MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8778
Mailing Address - Country:US
Mailing Address - Phone:713-507-6282
Mailing Address - Fax:936-442-6704
Practice Address - Street 1:19245 DAVID MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8778
Practice Address - Country:US
Practice Address - Phone:713-507-6282
Practice Address - Fax:936-442-6704
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist