Provider Demographics
NPI:1386628592
Name:THIDA, AYE (MD)
Entity Type:Individual
Prefix:
First Name:AYE
Middle Name:
Last Name:THIDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 HIGHWAY 6
Mailing Address - Street 2:STE.500A
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4369
Mailing Address - Country:US
Mailing Address - Phone:281-208-4600
Mailing Address - Fax:281-208-4608
Practice Address - Street 1:5201 HIGHWAY 6
Practice Address - Street 2:STE.500A
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4369
Practice Address - Country:US
Practice Address - Phone:281-208-4600
Practice Address - Fax:281-208-4608
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9917208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH32702Medicare UPIN