Provider Demographics
NPI:1730633181
Name:TAGHEHCHIAN, LAYLA LOUISE (PA-C)
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:LOUISE
Last Name:TAGHEHCHIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 WEST LOOP S STE 200G
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3535
Mailing Address - Country:US
Mailing Address - Phone:713-486-6520
Mailing Address - Fax:713-664-7929
Practice Address - Street 1:6500 WEST LOOP S STE 200G
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3535
Practice Address - Country:US
Practice Address - Phone:713-486-6520
Practice Address - Fax:713-664-7929
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-14
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12300363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical