Provider Demographics
NPI:1447977921
Name:GHIYAS, MOHAMMAD AFFAN (AUD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD AFFAN
Middle Name:
Last Name:GHIYAS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11439 MEADOWAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-5338
Mailing Address - Country:US
Mailing Address - Phone:630-344-3419
Mailing Address - Fax:
Practice Address - Street 1:2028 JUNIPER CT
Practice Address - Street 2:
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-1760
Practice Address - Country:US
Practice Address - Phone:630-344-3419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81572231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist