Provider Demographics
NPI:1790079648
Name:GHAEL, PRIYA (MD)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:GHAEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 TAUB LOOP
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6630 DE MOSS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-5004
Practice Address - Country:US
Practice Address - Phone:713-272-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275610207Q00000X
TXT2867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03916709Medicaid
NY000695941Medicaid
WI331945Medicare Oscar/Certification
NY000695941Medicaid
WI331944Medicare Oscar/Certification
WI331952Medicare Oscar/Certification
WI331954Medicare Oscar/Certification
WI331978Medicare Oscar/Certification
WI331043Medicare Oscar/Certification
WI331058Medicare Oscar/Certification
WI331943Medicare Oscar/Certification
WI331009Medicare Oscar/Certification
NY03916709Medicaid
NYW6L111Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification