Provider Demographics
NPI:1043249287
Name:DEMIAN, NAGI M (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAGI
Middle Name:M
Last Name:DEMIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:NAGI
Other - Middle Name:
Other - Last Name:DEMIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MD
Mailing Address - Street 1:6560 FANNIN ST STE 1280
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2753
Mailing Address - Country:US
Mailing Address - Phone:713-441-5577
Mailing Address - Fax:
Practice Address - Street 1:6560 FANNIN ST STE 1280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2753
Practice Address - Country:US
Practice Address - Phone:713-441-5577
Practice Address - Fax:713-793-1869
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20025204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89D304OtherBCBS
TX175800501Medicaid
TX8D9205Medicare PIN
TX89D304OtherBCBS