MEDICARE: VIVEK H DAYAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	K4308	TX
2	208000000X	Pediatrics Physician	K4308	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8M5250	OTHER		BC
2	371486934	OTHER		TRICARE

General Provider Information

NPI Number	:	1922173137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVEK H DAYAL MD

Provider Business Mailing Address
First Line	:	7215 WYOMING SPGS
Second Line	:	BLDG 3 STE 700
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4312
Country	:	US
Telephone Number	:	512-225-6345
Fax Number	:	512-225-6344

Provider Business Practice Location Address
First Line	:	7215 WYOMING SPGS
Second Line	:	BLDG 3 STE 700
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4312
Country	:	US
Telephone Number	:	512-225-6345
Fax Number	:	512-246-3340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	10/30/2015

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Directions to “ VIVEK H DAYAL MD” Practice Location

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