Individual
LEYLA MEHDINASAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17201 I H 45 S, SHENANDOAH, TX 77385
(936) 270-2099
Mailing address
17201 I H 45 S, SHENANDOAH, TX 77385-3311
(936) 270-2099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01072295A
IN
207R00000X
Internal Medicine Physician
35.099546
OH
208M00000X
Hospitalist Physician
Primary
Q9866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070940
—
OH
05
—
364862803
—
TX
05
—
3810025723
—
WV
Enumeration date
06/25/2012
Last updated
10/04/2018
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