Provider Demographics
NPI:1922270867
Name:MOHAMMED AYOUB MD,PA
Entity Type:Organization
Organization Name:MOHAMMED AYOUB MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:AYOUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-335-0300
Mailing Address - Street 1:1322 SPACE PARK DR
Mailing Address - Street 2:SUITE C197
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3400
Mailing Address - Country:US
Mailing Address - Phone:281-335-0300
Mailing Address - Fax:281-335-0355
Practice Address - Street 1:1322 SPACE PARK DR
Practice Address - Street 2:SUITE C197
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3400
Practice Address - Country:US
Practice Address - Phone:281-335-0300
Practice Address - Fax:281-335-0355
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOHAMMED AYOUB MD,PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK92192084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXX73784Medicare UPIN