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

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sonal R Dalal

Title

Office Manager

Phone

(979) 285-0007

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mauli R. Dalal, MD

  • Family Medicine Physician
  • Lake Jackson, TX
  • NPI 1669935524
  Medicare reassignment Care Compare group NPD
• Rajesh V Dalal, MD

  • Internal Medicine Physician
  • Lake Jackson, TX
  • NPI 1316928021
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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": "",
            "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
• Saleem Raslan, M.D.

• Internal Medicine Physician in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• 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.