Provider Demographics
NPI:1386361863
Name:BATISTA, AZYADEH
Entity type:Individual
Prefix:
First Name:AZYADEH
Middle Name:
Last Name:BATISTA
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 1:6361 S STADIUM LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1057
Mailing Address - Country:US
Mailing Address - Phone:281-396-6007
Mailing Address - Fax:
Practice Address - Street 1:6361 S STADIUM LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1057
Practice Address - Country:US
Practice Address - Phone:281-396-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist