Provider Demographics
NPI:1023608858
Name:AYOUBI, MAHSA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MAHSA
Middle Name:
Last Name:AYOUBI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7936 MIDWAY DEPOT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2157
Mailing Address - Country:US
Mailing Address - Phone:210-535-8040
Mailing Address - Fax:
Practice Address - Street 1:13700 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4332
Practice Address - Country:US
Practice Address - Phone:210-545-9208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59919183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist