Provider Demographics
NPI:1215922786
Name:AYAR, DIVYANG C (MD)
Entity type:Individual
Prefix:
First Name:DIVYANG
Middle Name:C
Last Name:AYAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 842117
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0031
Mailing Address - Country:US
Mailing Address - Phone:281-949-6020
Mailing Address - Fax:
Practice Address - Street 1:8619 BROADWAY ST
Practice Address - Street 2:STE 105
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8495
Practice Address - Country:US
Practice Address - Phone:281-949-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH189202085R0202X
TXK97182085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045069401Medicaid
TX045069401Medicaid
H18920Medicare UPIN