MEDICARE: DUA AYAD

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	183700000X	Pharmacy Technician	39844	TX

General Provider Information

NPI Number	:	1932893310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUA AYAD

Provider Business Mailing Address
First Line	:	9900 WURZBACH RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2212
Country	:	US
Telephone Number	:	210-696-1073
Fax Number	:

Provider Business Practice Location Address
First Line	:	11707 VANCE JACKSON RD APT 404
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-1461
Country	:	US
Telephone Number	:	210-763-0857
Fax Number	:

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

Provider Enumeration Date	:	06/07/2023
Last Update Date	:	06/07/2023

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Directions to “ DUA AYAD ” Practice Location

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