Provider Demographics
NPI:1134579238
Name:AYIK, SELDA
Entity type:Individual
Prefix:
First Name:SELDA
Middle Name:
Last Name:AYIK
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 1:7979 WESTHEIMER RD
Mailing Address - Street 2:APT 1306
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-4550
Mailing Address - Country:US
Mailing Address - Phone:713-815-1494
Mailing Address - Fax:
Practice Address - Street 1:11925 SOUTHWEST FWY # 3B
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2300
Practice Address - Country:US
Practice Address - Phone:832-460-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-18-74471103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXRBT-18-74471OtherREGISTERED BEHAVIOR TECHNICIAN