Provider Demographics
NPI:1336303759
Name:WALTER X .LOYOLA,M.D.,PA
Entity Type:Organization
Organization Name:WALTER X .LOYOLA,M.D.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:X
Authorized Official - Last Name:LOYOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-312-0607
Mailing Address - Street 1:3200 GLENHURST CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3448
Mailing Address - Country:US
Mailing Address - Phone:972-312-0607
Mailing Address - Fax:
Practice Address - Street 1:3060 COMMUNICATIONS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8449
Practice Address - Country:US
Practice Address - Phone:972-213-0607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1689676520OtherNPI
TX1215933403OtherNPI