Provider Demographics
NPI:1730404120
Name:TUKAYE, DEEPALI NIVAS (MD)
Entity type:Individual
Prefix:DR
First Name:DEEPALI
Middle Name:NIVAS
Last Name:TUKAYE
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 1:2555 GULF FWY S STE 500
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6742
Mailing Address - Country:US
Mailing Address - Phone:832-400-2227
Mailing Address - Fax:832-400-2228
Practice Address - Street 1:2555 GULF FWY S STE 500
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6742
Practice Address - Country:US
Practice Address - Phone:832-400-2227
Practice Address - Fax:832-400-2228
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA84654207RI0011X
ARE-10764207RI0011X
TXT9037207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology