Provider Demographics
NPI:1912915158
Name:LOYA, GEORGINA (MD)
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:LOYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 HIGHWAY 6 N
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1700
Mailing Address - Country:US
Mailing Address - Phone:281-550-0059
Mailing Address - Fax:281-550-0348
Practice Address - Street 1:7825 HIGHWAY 6 N
Practice Address - Street 2:SUITE 107
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1700
Practice Address - Country:US
Practice Address - Phone:281-550-0059
Practice Address - Fax:281-550-0348
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142431901Medicaid
TXH69303Medicare UPIN
TX142431901Medicaid