Provider Demographics
NPI:1760451181
Name:AYYAR, MONIKA S (DO)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:S
Last Name:AYYAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6560 FANNIN ST 1008
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2725
Mailing Address - Country:US
Mailing Address - Phone:281-207-2660
Mailing Address - Fax:281-207-2661
Practice Address - Street 1:6560 FANNIN ST STE 1008
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2725
Practice Address - Country:US
Practice Address - Phone:281-207-2660
Practice Address - Fax:281-207-2661
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8503208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX811929Medicaid
TXI18191Medicare UPIN
TX8D8706Medicare ID - Type Unspecified
TXTXB121803Medicare PIN
TX811929Medicaid