Mauli R. Dalal, MD
Individual provider Active NPI Family Medicine Physician · Lake Jackson, TX
NPI 1669935524 · NPPES record last updated Sep 25, 2025
Key facts
- NPI
- 1669935524
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- T8794 (TX)
- Practice address
- 192 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160 - Phone
- (979) 285-0007
- NPI assigned
- Apr 8, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Texas Medical Branch at Galveston, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Raj Dalal MD PA
Practice addresses (Care Compare)
192 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160
Phone (979) 236-9414
Hospital & facility affiliations
- CHI St Luke'S Health Brazosport
- HCA Houston Healthcare Pearland
- Sweeny Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220916000765 | TX | Practitioner - Family Practice | 2163840612 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T8794 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raj Dalal MD PA | Current |
Accepting new patients |
Locations
192 Abner Jackson Pkwy
Lake Jackson, TX 77566
Phone (979) 236-9414
Interoperability endpoints
- mauli.dalal@79721525673988.direct.elationemr.com
- mdalal456311@direct.stlukeshealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | T8794 | TX | Yes |
Addresses
Primary practice location
192 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160
Mailing address
192 Abner Jackson Pkwy
Lake Jackson, TX 77566-5160
Phone (979) 285-0007
Other providers in Lake Jackson, TX
- CVS Pharmacy Inc
- CVS Pharmacy Inc
- Cynthia Overholser DDS
- D. N. Bennett, MD PA
- Shunta Dailey
- Rajesh V Dalal
- Christian Damian
- Francis Dang
- Kayla H Dao
- Kimi L Dart
All providers in Lake Jackson, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.