Provider Demographics
NPI:1912353210
Name:FERGUSON, DALYA MUNVES (MD)
Entity Type:Individual
Prefix:DR
First Name:DALYA
Middle Name:MUNVES
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DALYA
Other - Middle Name:NICOLE
Other - Last Name:MUNVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5656 KELLEY ST STE 3OS62008
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-1967
Mailing Address - Country:US
Mailing Address - Phone:713-566-5098
Mailing Address - Fax:713-566-4583
Practice Address - Street 1:6500 WEST LOOP S STE 200E
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3535
Practice Address - Country:US
Practice Address - Phone:713-486-1330
Practice Address - Fax:713-512-2200
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8559208600000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery