Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | M3876 | TX |
NPI | 1053312009 |
---|---|
Provider Name | Dr. Roberto A Ayres |
First Address | Pharr, TX 78577-1614 |
Second Address | Edinburg, TX 78539-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 15/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182383304 | (05) | TX |
182383305 | (05) | TX |