| Doctor Name: | MR. LOY DENE LONG |
| NPI Number: | 1144252255 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | 616364 |
| Business Practice Address: | 710 S Gregg St Suite 100 Big Spring, TX - 797202425 |
| Business Phone Number: | 4322677411 |
| Business Fax Number: | 4322646442 |
| Mailing Address: | 710 S Gregg St, Suite 100 BIG SPRING |
| State: | TX |
| Postal Code: | 797202425 |
| Phone Number: | 4322677411 |
| Fax Number: | 4322646442 |
| NPI Enumeration Date: | 07/07/2006 |
| NPI Last Update Date: | 04/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 616364 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |