Provider Demographics
NPI:1215351598
Name:DEAYALA OBGYN ASSOCIATES OF HOUSTON PLLC
Entity type:Organization
Organization Name:DEAYALA OBGYN ASSOCIATES OF HOUSTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:EMILIO
Authorized Official - Last Name:DEAYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-827-4744
Mailing Address - Street 1:902 FROSTWOOD DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2420
Mailing Address - Country:US
Mailing Address - Phone:713-827-4744
Mailing Address - Fax:713-827-4766
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:SUITE 108
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2420
Practice Address - Country:US
Practice Address - Phone:713-827-4744
Practice Address - Fax:713-827-4766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207V00000X, 207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty