Provider Demographics
NPI:1154641736
Name:DANGAYACH, VICKAS (MD,MBA)
Entity Type:Individual
Prefix:DR
First Name:VICKAS
Middle Name:
Last Name:DANGAYACH
Suffix:
Gender:M
Credentials:MD,MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16811 SOUTHWEST FWY FL 3
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4728
Mailing Address - Country:US
Mailing Address - Phone:281-276-0836
Mailing Address - Fax:281-275-0760
Practice Address - Street 1:16811 SOUTHWEST FWY FL 3
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4728
Practice Address - Country:US
Practice Address - Phone:281-276-0836
Practice Address - Fax:281-275-0760
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5956208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX334756YT8BOtherMEDICARE
TX8GB511OtherBCBS TX
TX1306215OtherCIGNA
TX335988708Medicaid