Healthcare Provider Details

I. General information

NPI: 1952332355
Provider Name (Legal Business Name): VIJAYA L KAILA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 10/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W 27TH ST STE 185
HOUSTON TX
77008-1438
US

IV. Provider business mailing address

1900 NORTH LOOP W STE 390
HOUSTON TX
77018-8148
US

V. Phone/Fax

Practice location:
  • Phone: 713-426-1320
  • Fax: 713-426-4038
Mailing address:
  • Phone: 832-708-2686
  • Fax: 713-694-6065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberK1490
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: