Provider Demographics
NPI:1164209482
Name:NOYOLA, ORLANDO II (LAT)
Entity Type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:
Last Name:NOYOLA
Suffix:II
Gender:M
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N EBONY ST
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1912
Mailing Address - Country:US
Mailing Address - Phone:956-331-9138
Mailing Address - Fax:
Practice Address - Street 1:1605 N EBONY ST
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-1912
Practice Address - Country:US
Practice Address - Phone:956-331-9138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT6632207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine