Healthcare Provider Details

I. General information

NPI: 1740670975
Provider Name (Legal Business Name): AYESHA MOHIUDDIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23964 KATY FWY STE 300
KATY TX
77494-8490
US

IV. Provider business mailing address

930 FROSTWOOD DR STE 2.200
HOUSTON TX
77024-2450
US

V. Phone/Fax

Practice location:
  • Phone: 281-644-8955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ7430
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: