Healthcare Provider Details

I. General information

NPI: 1619938958
Provider Name (Legal Business Name): IGNATIUS P OYULA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4215 TOWNE LAKE CT
IRVING TX
75061-9000
US

IV. Provider business mailing address

4215 TOWNE LAKE CT
IRVING TX
75061-9000
US

V. Phone/Fax

Practice location:
  • Phone: 972-464-7282
  • Fax:
Mailing address:
  • Phone: 972-464-7282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number223118
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD10100
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number223118
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: