Basic Information
Provider Information
NPI: 1437579364
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AYVACI
FirstName: EMINE
MiddleName: RABIA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: OZAY
OtherFirstName: EMINE
OtherMiddleName: RABIA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 2146450624
FaxNumber: 2146450078
Practice Location
Address1: 5200 HARRY HINES BLVD
Address2:  
City: DALLAS
State: TX
PostalCode: 75235
CountryCode: US
TelephoneNumber: 4694199606
FaxNumber: 2146489627
Other Information
ProviderEnumerationDate: 04/18/2014
LastUpdateDate: 07/11/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084P0800XR6966TXY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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