Provider Demographics
NPI:1568411080
Name:SHAYA, TAYMA S (MD)
Entity Type:Individual
Prefix:
First Name:TAYMA
Middle Name:S
Last Name:SHAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAYMA
Other - Middle Name:S
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16605 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3501
Mailing Address - Country:US
Mailing Address - Phone:281-201-2230
Mailing Address - Fax:281-215-5092
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 350
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3501
Practice Address - Country:US
Practice Address - Phone:281-201-2230
Practice Address - Fax:281-215-5092
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2739207Q00000X, 202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176776604Medicaid
TX1568411080OtherBLUE CROSS BLUE SHIELD
TX176776605Medicaid
TX8EF700OtherBLUE CROSS BLUE SHIELD
TX176776604Medicaid
TX8L21201Medicare PIN
TX8A0844Medicare PIN
TX1568411080OtherBLUE CROSS BLUE SHIELD