Individual
LISA AYOUB-RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01069736A
IN
208000000X
Pediatrics Physician
Primary
43986
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000717320
ANTHEM PROVIDER NUMBER
IN
05
—
201023560
—
IN
Enumeration date
04/17/2008
Last updated
10/17/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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