Provider Demographics
NPI:1134409709
Name:AYALEW, YORDANOS B
Entity type:Individual
Prefix:
First Name:YORDANOS
Middle Name:B
Last Name:AYALEW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7457 HARWIN DR
Mailing Address - Street 2:SUITE 303A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2026
Mailing Address - Country:US
Mailing Address - Phone:713-782-0200
Mailing Address - Fax:832-263-0618
Practice Address - Street 1:7457 HARWIN DR
Practice Address - Street 2:SUITE 303A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2026
Practice Address - Country:US
Practice Address - Phone:713-782-0200
Practice Address - Fax:832-263-0618
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10006763416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport