Healthcare Provider Details
I. General information
NPI: 1376731117
Provider Name (Legal Business Name): ASHFAQUE SAYA MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/05/2007
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
735 N WALDRIP ST
GRAND SALINE TX
75140-1555
US
IV. Provider business mailing address
735 N WALDRIP ST
GRAND SALINE TX
75140-1555
US
V. Phone/Fax
- Phone: 903-962-4500
- Fax: 903-962-4588
- Phone: 903-962-4500
- Fax: 903-962-4588
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | M 5914 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
ASHFAQUE
SAYA
Title or Position: PHYSICIAN/OFFICER
Credential: M.D.
Phone: 903-962-4500