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General NPI Number Information
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NPI Number | 1730692864
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Entity Type | Organization
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Legal Business Name | ESSENTIAL DIABETES AND ENDOCRINE CARE
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Dates
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Enumeration Date | 11/11/2017
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 6243 FAIRMONT PKWY STE 104
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City | PASADENA
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State | TX
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Zip | 77505
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Country | US
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Telephone | 410-493-8472
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Fax | 410-493-8472
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Provider Business Mailing Address
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Address Line | 1825 CASTLE OAKS DR
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City | PEARLAND
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State | TX
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Zip | 77581-6395
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Country | US
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Telephone | 410-493-8472
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Fax |
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. ALIYA SAKINAH HAYES
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Credential | MD
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Telephone | 410-493-8472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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