Provider Demographics
NPI:1083911549
Name:PRANAV LOYALKA MD PA
Entity Type:Organization
Organization Name:PRANAV LOYALKA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRANAV
Authorized Official - Middle Name:
Authorized Official - Last Name:LOYALKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-797-0180
Mailing Address - Street 1:6624 FANNIN ST
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2333
Mailing Address - Country:US
Mailing Address - Phone:713-797-0180
Mailing Address - Fax:713-797-1217
Practice Address - Street 1:7125 NEW SANGER RD
Practice Address - Street 2:STE A
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-4053
Practice Address - Country:US
Practice Address - Phone:713-797-0180
Practice Address - Fax:713-797-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4542207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty