Provider Demographics
NPI:1316291016
Name:AYESHA, RUBEENA (NP)
Entity type:Individual
Prefix:MRS
First Name:RUBEENA
Middle Name:
Last Name:AYESHA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13280 TRAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-3748
Mailing Address - Country:US
Mailing Address - Phone:917-538-9431
Mailing Address - Fax:
Practice Address - Street 1:5005 W 34TH ST STE 106C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-4200
Practice Address - Country:US
Practice Address - Phone:713-808-9701
Practice Address - Fax:832-667-8541
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX827700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily