Provider Demographics
NPI:1386959112
Name:LOSCH, JOHN B II
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:LOSCH
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9151 BOULEVARD 26 STE 150B
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-5600
Mailing Address - Country:US
Mailing Address - Phone:682-214-2280
Mailing Address - Fax:
Practice Address - Street 1:215 KINGWOOD EXECUTIVE DR STE 150
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2765
Practice Address - Country:US
Practice Address - Phone:682-683-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1386959112363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN