Provider Demographics
NPI:1144586322
Name:LOYA, FERNANDO H (DMD)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:H
Last Name:LOYA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-1024
Mailing Address - Country:US
Mailing Address - Phone:512-472-2511
Mailing Address - Fax:512-472-2521
Practice Address - Street 1:901 E 15TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-1024
Practice Address - Country:US
Practice Address - Phone:512-472-2511
Practice Address - Fax:512-472-2521
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19163122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist