Provider Demographics
NPI:1790972214
Name:NIRMAL S. BUAL, MD, PA
Entity Type:Organization
Organization Name:NIRMAL S. BUAL, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NIRMAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BUAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:281-206-0134
Mailing Address - Street 1:PO BOX 690646
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-0646
Mailing Address - Country:US
Mailing Address - Phone:281-206-0134
Mailing Address - Fax:713-955-5201
Practice Address - Street 1:21216 NORTHWEST FWY STE 650
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4697
Practice Address - Country:US
Practice Address - Phone:281-206-0134
Practice Address - Fax:713-955-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2022-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4267174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00407KMedicare PIN