Individual
AYAD LATIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 510-1186
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P4669
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332225701
—
TX
05
—
332225704
—
TX
01
—
75-2616977-042
TRICARE
TX
01
—
8DX590
BCBS
TX
Enumeration date
07/11/2010
Last updated
01/20/2016
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