Provider Demographics
NPI:1760988695
Name:DAIOUB, ASHLY KAREMA
Entity Type:Individual
Prefix:
First Name:ASHLY
Middle Name:KAREMA
Last Name:DAIOUB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 S PLEASANT VALLEY RD APT 427
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1889
Mailing Address - Country:US
Mailing Address - Phone:915-401-9353
Mailing Address - Fax:
Practice Address - Street 1:2409 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1112
Practice Address - Country:US
Practice Address - Phone:512-471-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-31
Last Update Date:2018-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program