Provider Demographics
NPI:1033545512
Name:AYALA ENT & FACIAL PLASTIC SURGERY PLLC
Entity Type:Organization
Organization Name:AYALA ENT & FACIAL PLASTIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-4515
Mailing Address - Street 1:2821 MICHAEL ANGELO STE 201
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-1406
Mailing Address - Country:US
Mailing Address - Phone:956-631-4515
Mailing Address - Fax:956-661-8205
Practice Address - Street 1:2821 MICHAEL ANGELO STE 201
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1406
Practice Address - Country:US
Practice Address - Phone:956-631-4515
Practice Address - Fax:956-661-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4845207YX0007X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty