Provider Demographics
NPI:1124009063
Name:NAYAK, DEVRAJ U (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVRAJ
Middle Name:U
Last Name:NAYAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 10TH ST.
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114
Mailing Address - Country:US
Mailing Address - Phone:830-216-2716
Mailing Address - Fax:830-216-2150
Practice Address - Street 1:495 10TH ST.
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114
Practice Address - Country:US
Practice Address - Phone:830-216-2716
Practice Address - Fax:830-216-2150
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8450207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165220801Medicaid
TX1085555458Medicare UPIN
TXI08458Medicare UPIN
TX8B9139Medicare PIN
TX8B9139Medicare ID - Type Unspecified