Provider Demographics
NPI:1467277459
Name:NOYOLA, MARY C (APRN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:NOYOLA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 W ENNIS AVE
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-8003
Mailing Address - Country:US
Mailing Address - Phone:972-875-8600
Mailing Address - Fax:972-875-8481
Practice Address - Street 1:2200 W ENNIS AVE
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-8003
Practice Address - Country:US
Practice Address - Phone:972-875-8600
Practice Address - Fax:972-875-8481
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1172160363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology