Provider Demographics
NPI:1609199926
Name:GHAYAS, MADIHA (MD)
Entity Type:Individual
Prefix:
First Name:MADIHA
Middle Name:
Last Name:GHAYAS
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 1:19255 PARK ROW STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7310
Mailing Address - Country:US
Mailing Address - Phone:346-251-5901
Mailing Address - Fax:832-321-3516
Practice Address - Street 1:19255 PARK ROW STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7310
Practice Address - Country:US
Practice Address - Phone:346-251-5901
Practice Address - Fax:832-321-3516
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP13122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DB115OtherBCBS