Provider Demographics
NPI:1457943961
Name:BAYONA, PAOLA EMILIA
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:EMILIA
Last Name:BAYONA
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 1:25722 KINGSLAND BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2643
Mailing Address - Country:US
Mailing Address - Phone:713-785-1272
Mailing Address - Fax:
Practice Address - Street 1:25722 KINGSLAND BLVD STE 205
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2643
Practice Address - Country:US
Practice Address - Phone:713-785-1272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0000207R00000X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine