Provider Demographics
NPI:1518220532
Name:AYSO HEALTHCARE
Entity Type:Organization
Organization Name:AYSO HEALTHCARE
Other - Org Name:AYSO HEALTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:YENNY
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:NIAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-301-9407
Mailing Address - Street 1:19875 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6721
Mailing Address - Country:US
Mailing Address - Phone:281-301-9407
Mailing Address - Fax:281-671-8856
Practice Address - Street 1:3214 BROOK ARBOR LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3851
Practice Address - Country:US
Practice Address - Phone:281-301-9407
Practice Address - Fax:281-671-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology