Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 21650 | OH |
Y | 1223G0001X | General Practice | 103569 | CA |
Y | 213EG0000X | General Practice | 103569 | CA |
N | 1223G0001X | General Practice | 22541 | TX |
N | 213EG0000X | General Practice | 22541 | TX |
NPI | 1730149840 |
---|---|
Provider Name | Nader N Nagavi |
First Address | Farmers Branch, TX 75234-6342 |
Second Address | Carlsbad, CA 92009-8489 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 29/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2343753 | (05) | OH |