Provider Demographics
NPI:1679736078
Name:DICHOSO, DARYL (MD)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:
Last Name:DICHOSO
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 1:3733-1 WESTHEIMER RD PMB #781
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5226
Mailing Address - Country:US
Mailing Address - Phone:888-897-2724
Mailing Address - Fax:800-376-2814
Practice Address - Street 1:3733-1 WESTHEIMER RD # 781
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5226
Practice Address - Country:US
Practice Address - Phone:888-897-2724
Practice Address - Fax:800-376-2814
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9258207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L3442Medicare PIN