Provider Demographics
NPI:1871823070
Name:NOYOLA, MARTIN JR (PT)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:NOYOLA
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2924
Mailing Address - Country:US
Mailing Address - Phone:956-687-4560
Mailing Address - Fax:956-618-1342
Practice Address - Street 1:500 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2924
Practice Address - Country:US
Practice Address - Phone:956-687-4560
Practice Address - Fax:956-618-1342
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1193323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist