Healthcare Provider Details

I. General information

NPI: 1235926361
Provider Name (Legal Business Name): AYA MAHMOUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 ELDRIDGE PKWY APT 2337
HOUSTON TX
77077-1678
US

IV. Provider business mailing address

1415 ELDRIDGE PKWY APT 2337
HOUSTON TX
77077-1678
US

V. Phone/Fax

Practice location:
  • Phone: 832-922-8606
  • Fax:
Mailing address:
  • Phone: 832-922-8606
  • Fax: 832-922-8606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: