Provider Demographics
NPI:1376152538
Name:DAYAL FAMILY MEDICINE PA
Entity Type:Organization
Organization Name:DAYAL FAMILY MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAURI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-604-6534
Mailing Address - Street 1:3032 MARINA BAY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4668
Mailing Address - Country:US
Mailing Address - Phone:832-604-6534
Mailing Address - Fax:832-604-6531
Practice Address - Street 1:3032 MARINA BAY DR STE 200
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-4668
Practice Address - Country:US
Practice Address - Phone:832-604-6534
Practice Address - Fax:832-604-6531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty