Healthcare Provider Details

I. General information

NPI: 1710062237
Provider Name (Legal Business Name): ROBERTO A AYRES MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SOUTH JACKSON STE 7
MCALLEN TX
78501
US

IV. Provider business mailing address

PO BOX 2945
MCALLEN TX
78502-2945
US

V. Phone/Fax

Practice location:
  • Phone: 956-688-5864
  • Fax:
Mailing address:
  • Phone: 956-688-5864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberM3876
License Number StateTX

VIII. Authorized Official

Name: DR. ROBERTO A AYRES
Title or Position: PRESIDENT
Credential:
Phone: 956-688-5864