Raj Dalal MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K0702 Issued in TX

Legal business name

RAJ DALAL MD PA

Practice address

192 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160

Phone

(979) 285-0007

Fax

(979) 529-2309

NPI assigned

Feb 1, 2018

Organization subpart

No

Name

Sonal R Dalal

Title

Office Manager

Phone

(979) 285-0007

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mauli R. Dalal, MD

  • Family Medicine Physician
  • Lake Jackson, TX
  • NPI 1669935524

  TX

  Medicare reassignment Care Compare group NPD
• Rajesh V Dalal, MD

  • Internal Medicine Physician
  • Lake Jackson, TX
  • NPI 1316928021

  Internal Medicine, TX

  Medicare reassignment Care Compare group NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in TX

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 16, 2018.

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1144729492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 ABNER JACKSON PKWY",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 ABNER JACKSON PKWY",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665160",
            "telephone_number": "979-285-0007",
            "fax_number": "979-529-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJ DALAL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "DALAL",
        "authorized_official_first_name": "SONAL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "979-285-0007"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K0702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T4119",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Price, OTR
• Primary Care Associates of Lake Jackson, PLLC
• Mark A Provenzano, O.D.
• Quad/Med, LLC
• R. Kattegummula, M.D, P.a.
• Emily Ramirez, DC
• Ramitra Dental Implants & Periodontics PLLC
• Danette Randall, P.T.
• Syed Rashid
• Rebecca Ann Inc

• All providers in Lake Jackson, TX
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.