MEDICARE: MR. LUIS ALBERTO LOYA PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA18703	TX

General Provider Information

NPI Number	:	1033944533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LUIS ALBERTO LOYA PA-C

Provider Business Mailing Address
First Line	:	5323 HARRY HINES BLVD STOP 7200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-9090
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD STOP 7200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-6830
Country	:	US
Telephone Number	:	915-867-7430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2024
Last Update Date	:	06/01/2026

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