Provider Demographics
NPI:1902384688
Name:LOYA, LAURA ANN (PTA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:LOYA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-0092
Mailing Address - Country:US
Mailing Address - Phone:956-689-5301
Mailing Address - Fax:956-689-2004
Practice Address - Street 1:100 N HWY 77 STE I
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-4010
Practice Address - Country:US
Practice Address - Phone:956-689-5301
Practice Address - Fax:956-689-2004
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2056302225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant