Individual provider Active NPI

Ilia Ayub, LSA

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1568580058
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1012927 Issued in TX
Practice address
14947 Camino Rancho Dr
Houston, TX 77083-3222
Phone
(713) 823-0197
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X SA00329 TX
Surgical Technologist 246ZS0410X SA00329 TX
Surgical Technologist 246ZS0410X 2947 TX
Family Nurse Practitioner 363LF0000X 1012927 TX Primary

Addresses

Primary practice location

14947 Camino Rancho Dr
Houston, TX 77083-3222

Mailing address

14947 Camino Rancho Dr
Houston, TX 77083-3222
Phone (713) 823-0197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA00329TXMDSurgical Assistant
2947TXMDSurgical Technologist
1012927TXMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1568580058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14947 CAMINO RANCHO DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770833222",
            "telephone_number": "713-823-0197",
            "fax_number": "713-823-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14947 CAMINO RANCHO DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770833222",
            "telephone_number": "713-823-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYUB",
        "first_name": "ILIA",
        "credential": "LSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-04-23",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00329",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "SA00329",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "2947",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1012927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.