Provider Demographics
NPI:1730197120
Name:LOESCHEN, STEVE K (DO,)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:K
Last Name:LOESCHEN
Suffix:
Gender:M
Credentials:DO,
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:K
Other - Last Name:LOESCHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-8800
Mailing Address - Fax:
Practice Address - Street 1:2608 BROCKTON DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4414
Practice Address - Country:US
Practice Address - Phone:512-654-4050
Practice Address - Fax:512-654-4051
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G295495Medicare UPIN