Provider Demographics
NPI:1487616512
Name:DAYA, NADIRKHAN N (MD)
Entity type:Individual
Prefix:DR
First Name:NADIRKHAN
Middle Name:N
Last Name:DAYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4323 N JOSEY LN
Mailing Address - Street 2:STE 100
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4633
Mailing Address - Country:US
Mailing Address - Phone:214-731-9007
Mailing Address - Fax:214-731-0822
Practice Address - Street 1:4323 N JOSEY LN
Practice Address - Street 2:STE 100
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4633
Practice Address - Country:US
Practice Address - Phone:214-731-9007
Practice Address - Fax:214-731-0822
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0122207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154268001Medicaid
TXH27214Medicare UPIN
TX154268001Medicaid