Provider Demographics
NPI:1073576138
Name:MINDIKOGLU, AYSE LEYLA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:AYSE
Middle Name:LEYLA
Last Name:MINDIKOGLU
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 MAIN ST STE 1450
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2346
Mailing Address - Country:US
Mailing Address - Phone:832-355-1400
Mailing Address - Fax:
Practice Address - Street 1:6620 MAIN ST STE 1450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2346
Practice Address - Country:US
Practice Address - Phone:832-355-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD62280207RG0100X
TXQ7427207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD64874901OtherBLUE CROSS/BLUE SHIELD
DE1073576138Medicaid
MD407585400Medicaid
DE1073576138Medicaid
MDL366Medicare PIN
I31385Medicare UPIN