Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01072669A | IN |
N | 207RC0000X | Internist - Cardiovascular Disease | 35.090288 | OH |
Y | 207RI0011X | Interventional Cardiology | 01072669A | IN |
N | 207RI0011X | Interventional Cardiology | 35.090288 | OH |
NPI | 1104948017 |
---|---|
Provider Name | Ali Ayoubi |
First Address | Shenandoah, TX 77385-3316 |
Second Address | Shenandoah, TX 77385-3316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 18/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2796863 | (05) | OH |
374388201 | (05) | TX |