Individual provider · NPI-1

Jose Mario Ayala, MD

Internal Medicine · San Marcos, TX

NPI number1114960663
StatusActive
Last updated in NPPESDec 28, 2018

Details

NPI
1114960663
Entity type
Individual (NPI-1)
Name
Jose Mario Ayala
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 13, 2006
Last updated
Dec 28, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineM5037TXYes
207RA0000X Internal Medicine, Adolescent Medicine036104962IL

Practice location

1301 Wonder World Dr
San Marcos, TX 78666-7533

Phone 512-353-8979

Mailing address

1301 Wonder World Dr
San Marcos, TX 78666-7533

Phone 512-353-8979

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