| Dayal Family Medicine Pa | |
|
3032 Marina Bay Dr Ste 200 League City TX 77573-4668 | |
| (832) 604-6534 | |
| (832) 604-6531 |
| Full Name | Dayal Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 3032 Marina Bay Dr Ste 200, League City, Texas |
| Authorized Official Name and Position | Gauri Dayal (OWNER) |
| Authorized Official Contact | 8326046534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dayal Family Medicine Pa 3032 Marina Bay Dr Ste 200 League City TX 77573-4668 Ph: (832) 604-6534 | Dayal Family Medicine Pa 3032 Marina Bay Dr Ste 200 League City TX 77573-4668 Ph: (832) 604-6534 |
| NPI Number | 1376152538 |
|---|---|
| Provider Enumeration Date | 07/23/2020 |
| Last Update Date | 11/11/2020 |
| Medicare PECOS PAC ID | 6901223817 |
|---|---|
| Medicare Enrollment ID | O20200824001811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376152538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kathleen H Ko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649242330 PECOS PAC ID: 4486625076 Enrollment ID: I20040805000852 |
| Provider Name | Gauri Dayal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538160635 PECOS PAC ID: 2062658289 Enrollment ID: I20200824002007 |
| Provider Name | Niki Rose Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083140891 PECOS PAC ID: 6406125087 Enrollment ID: I20220203001065 |
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