Provider Demographics
NPI:1720872187
Name:AYALA, KIMBERLEY
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:AYALA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:KIMBERLEY
Other - Middle Name:
Other - Last Name:SCHEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4400 LAKEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5898
Mailing Address - Country:US
Mailing Address - Phone:940-369-4400
Mailing Address - Fax:
Practice Address - Street 1:4400 LAKEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-5898
Practice Address - Country:US
Practice Address - Phone:940-369-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program