Provider Demographics
NPI:1952332355
Name:KAILA, VIJAYA L (MD)
Entity Type:Individual
Prefix:
First Name:VIJAYA
Middle Name:L
Last Name:KAILA
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 1:1900 NORTH LOOP W STE 390
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8148
Mailing Address - Country:US
Mailing Address - Phone:832-708-2686
Mailing Address - Fax:713-694-6065
Practice Address - Street 1:1740 W 27TH ST STE 185
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1438
Practice Address - Country:US
Practice Address - Phone:713-426-1320
Practice Address - Fax:713-426-4038
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1490207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046631001Medicaid
TXK1490OtherMEDICAL LICENSE
TX885290Medicare PIN
TXK1490OtherMEDICAL LICENSE