Provider Demographics
NPI:1679936868
Name:AYOUB, FARES WALID (MD)
Entity type:Individual
Prefix:
First Name:FARES
Middle Name:WALID
Last Name:AYOUB
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 1:7200 CAMBRIDGE ST STE 8B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4202
Mailing Address - Country:US
Mailing Address - Phone:713-798-0950
Mailing Address - Fax:713-798-8489
Practice Address - Street 1:7200 CAMBRIDGE ST STE 8B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4202
Practice Address - Country:US
Practice Address - Phone:713-798-0950
Practice Address - Fax:713-798-8489
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT7857207RG0100X, 207RG0100X
IL036148291207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program