Basic Information
| Provider Information | |||||||||
| NPI: | 1386891695 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOY | ||||||||
| FirstName: | BRIENNE | ||||||||
| MiddleName: | JANSEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 616788 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328616788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4075336837 | ||||||||
| FaxNumber: | 4077700661 | ||||||||
| Practice Location | |||||||||
| Address1: | 5104 HARRISBURG BLVD STE 800 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770110001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8326674150 | ||||||||
| FaxNumber: | 8338539420 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2008 | ||||||||
| LastUpdateDate: | 11/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 11/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 322329 | LA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 47925 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 20997 | NV | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 04-44574 | KS | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 62983 | AZ | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 88895 | GA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | S2102 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 830796 | 01 | TX | MEDICARE | OTHER | 4101404-01 | 05 | TX | MEDICAID |