Provider Demographics
NPI:1457312423
Name:BABAIAN, NAIRA S (MDPA)
Entity Type:Individual
Prefix:MRS
First Name:NAIRA
Middle Name:S
Last Name:BABAIAN
Suffix:
Gender:F
Credentials:MDPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5928 W PARKER RD
Mailing Address - Street 2:STE 1200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:972-403-0800
Mailing Address - Fax:972-403-0844
Practice Address - Street 1:5928 W PARKER RD
Practice Address - Street 2:STE 1200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-403-0800
Practice Address - Fax:972-403-0844
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5787207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G78820Medicare UPIN
00666LMedicare ID - Type Unspecified