Provider Demographics
NPI:1386891695
Name:LOY, BRIENNE JANSEN (MD)
Entity type:Individual
Prefix:DR
First Name:BRIENNE
Middle Name:JANSEN
Last Name:LOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:407-533-6837
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:5104 HARRISBURG BLVD STE 800
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-0001
Practice Address - Country:US
Practice Address - Phone:832-667-4150
Practice Address - Fax:833-853-9420
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA322329207Q00000X
CO47925207Q00000X
NV20997207Q00000X
KS04-44574207Q00000X
AZ62983207Q00000X
GA88895207Q00000X
TXS2102207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX830796OtherMEDICARE
TX4101404-01Medicaid