Provider Demographics
NPI:1033175872
Name:NORTHSIDE GASTROENTEROLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:NORTHSIDE GASTROENTEROLOGY ASSOCIATES PA
Other - Org Name:AYUB HUSSAIN, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AYUB
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-477-9305
Mailing Address - Street 1:10425 HUFFMEISTER RD STE 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3429
Mailing Address - Country:US
Mailing Address - Phone:281-477-9305
Mailing Address - Fax:281-477-9319
Practice Address - Street 1:10425 HUFFMEISTER RD STE 310
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3429
Practice Address - Country:US
Practice Address - Phone:281-477-9305
Practice Address - Fax:281-477-9319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2334174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty