Provider Demographics
NPI:1538160635
Name:DAYAL, GAURI (MD)
Entity type:Individual
Prefix:MRS
First Name:GAURI
Middle Name:
Last Name:DAYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3032 MARINA BAY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4668
Mailing Address - Country:US
Mailing Address - Phone:832-604-6534
Mailing Address - Fax:832-604-6531
Practice Address - Street 1:3032 MARINA BAY DR STE 200
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-4668
Practice Address - Country:US
Practice Address - Phone:832-604-6534
Practice Address - Fax:832-604-6531
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA0122311OtherDPS
BD8005402OtherUS DEA
OTH000Medicare UPIN