Provider Demographics
NPI:1376608125
Name:GARYALI, ANIL (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:
Last Name:GARYALI
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:PO BOX 19861
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-5861
Mailing Address - Country:US
Mailing Address - Phone:713-480-0053
Mailing Address - Fax:832-218-2928
Practice Address - Street 1:7887 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2013
Practice Address - Country:US
Practice Address - Phone:713-480-0053
Practice Address - Fax:832-218-2928
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2014-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5176207RG0300X
AZ33308207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189229101Medicaid
TX189229101Medicaid