Healthcare Provider Details

I. General information

NPI: 1265734545
Provider Name (Legal Business Name): PRANAV LOYALKA MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16659 SOUTHWEST FWY STE 481
SUGAR LAND TX
77479-2968
US

IV. Provider business mailing address

6624 FANNIN ST STE 2120
HOUSTON TX
77030-2333
US

V. Phone/Fax

Practice location:
  • Phone: 713-797-0180
  • Fax: 713-797-1217
Mailing address:
  • Phone: 713-797-0180
  • Fax: 713-797-1217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PRANAV LOYALKA
Title or Position: DIRECTOR/OWNER
Credential: MD
Phone: 713-797-0180