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General NPI Number Information
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NPI Number | 1801661301
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Entity Type | Individual
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Provider Name | JORGE DANIEL AYALA
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Gender | Male
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Dates
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Enumeration Date | 11/15/2023
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 19115 FARM TO MARKET ROAD 2252 SUITE 8
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City | GARDEN RIDGE
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State | TX
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Zip | 78266
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Country | US
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Telephone | 956-342-7189
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Fax |
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Provider Business Mailing Address
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Address Line | 19115 FARM TO MARKET ROAD 2252 SUITE 8
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City | GARDEN RIDGE
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State | TX
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Zip | 78266
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Country | US
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Telephone | 956-342-7189
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 15922
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License Number State | TX
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