Provider Demographics
NPI:1790044261
Name:ARYA, SHYLAJA N (DPM)
Entity Type:Individual
Prefix:DR
First Name:SHYLAJA
Middle Name:N
Last Name:ARYA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:SHYLA
Other - Middle Name:NARASIMHAN
Other - Last Name:ARYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:3104 E INDIAN SCHOOL RD STE 110
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-6873
Mailing Address - Country:US
Mailing Address - Phone:602-309-8788
Mailing Address - Fax:
Practice Address - Street 1:3104 E INDIAN SCHOOL RD STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6873
Practice Address - Country:US
Practice Address - Phone:602-309-8788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPOD-000940213ES0103X
TX2122213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2122OtherTEXAS LICENSE