Provider Demographics
NPI:1518151158
Name:BAGHDASSARIAN, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BAGHDASSARIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 W 15TH ST.
Mailing Address - Street 2:STE A
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7790
Mailing Address - Country:US
Mailing Address - Phone:972-379-2416
Mailing Address - Fax:972-867-1018
Practice Address - Street 1:3809 W 15TH ST.
Practice Address - Street 2:STE A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7790
Practice Address - Country:US
Practice Address - Phone:972-379-2416
Practice Address - Fax:972-867-1018
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7139207V00000X
WAMD60302037207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology