Provider Demographics
NPI:1194082214
Name:BASCO, LOANNE (NP)
Entity type:Individual
Prefix:
First Name:LOANNE
Middle Name:
Last Name:BASCO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LOANNE
Other - Middle Name:
Other - Last Name:DUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12418 BRENTLEYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5537
Mailing Address - Country:US
Mailing Address - Phone:713-391-4556
Mailing Address - Fax:
Practice Address - Street 1:10777 KUYKENDAHL RD
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2772
Practice Address - Country:US
Practice Address - Phone:281-907-4104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX738342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily