Provider Demographics
NPI:1881770576
Name:BUAL, NIRMAL S (MD, PA)
Entity type:Individual
Prefix:
First Name:NIRMAL
Middle Name:S
Last Name:BUAL
Suffix:
Gender:M
Credentials:MD, PA
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 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 1:6006 THEALL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-1403
Practice Address - Country:US
Practice Address - Phone:281-206-0134
Practice Address - Fax:713-955-5201
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4267207RC0000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080530101Medicaid
B21542Medicare UPIN
TX85650KMedicare PIN