Provider Demographics
NPI:1053657577
Name:GUIRGUIS, FADY (DDS)
Entity Type:Individual
Prefix:DR
First Name:FADY
Middle Name:
Last Name:GUIRGUIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9648 FM 1960 BYPASS RD W.
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-6558
Mailing Address - Country:US
Mailing Address - Phone:917-602-3213
Mailing Address - Fax:
Practice Address - Street 1:9648 FM 1960 BYPASS RD W
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4039
Practice Address - Country:US
Practice Address - Phone:917-602-3213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D102524800122300000X
NY056888122300000X
TX31480122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist