Provider Demographics
NPI:1245854140
Name:AYALA, PAMELA STEFANY
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:STEFANY
Last Name:AYALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 CLYDESDALE DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0246
Mailing Address - Country:US
Mailing Address - Phone:940-206-2118
Mailing Address - Fax:
Practice Address - Street 1:3229 CLYDESDALE DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0246
Practice Address - Country:US
Practice Address - Phone:940-206-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse