Provider Demographics
NPI:1407966906
Name:BHAGIA, VIJAY (DMD, MS)
Entity Type:Individual
Prefix:
First Name:VIJAY
Middle Name:
Last Name:BHAGIA
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 CLEAR LAKE CITY BLVD # C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-8103
Mailing Address - Country:US
Mailing Address - Phone:281-286-8945
Mailing Address - Fax:
Practice Address - Street 1:1140 CLEAR LAKE CITY BLVD # C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-8103
Practice Address - Country:US
Practice Address - Phone:281-286-8945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics