Provider Demographics
NPI:1558593418
Name:NUNEZ, SEBASTIAN M (DDS)
Entity Type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:M
Last Name:NUNEZ
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 1:18707 EGRET BAY BLVD APT 209
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3813
Mailing Address - Country:US
Mailing Address - Phone:409-938-8018
Mailing Address - Fax:409-933-4737
Practice Address - Street 1:2434 CEDAR DR
Practice Address - Street 2:
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-3916
Practice Address - Country:US
Practice Address - Phone:409-938-8018
Practice Address - Fax:409-933-4737
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24709122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist