Provider Demographics
NPI:1528228855
Name:AYALLOORE, AMY (MS, PT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:AYALLOORE
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 LEESHIRE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-4037
Mailing Address - Country:US
Mailing Address - Phone:713-665-4729
Mailing Address - Fax:
Practice Address - Street 1:4055 LEESHIRE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-4037
Practice Address - Country:US
Practice Address - Phone:713-665-4729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34520174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist