Provider Demographics
NPI:1003087230
Name:HAYNIE, AISHA C (MD, MPA)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:C
Last Name:HAYNIE
Suffix:
Gender:F
Credentials:MD, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 WEST LOOP S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3588
Mailing Address - Country:US
Mailing Address - Phone:713-439-6913
Mailing Address - Fax:
Practice Address - Street 1:2223 WEST LOOP S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3588
Practice Address - Country:US
Practice Address - Phone:713-439-6913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-15
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8708207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L24816Medicare PIN