Provider Demographics
NPI:1629012059
Name:DIAZ-BAJSEL, CORINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CORINA
Middle Name:
Last Name:DIAZ-BAJSEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 LAWNDALE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77023-3840
Mailing Address - Country:US
Mailing Address - Phone:713-926-8899
Mailing Address - Fax:713-923-7000
Practice Address - Street 1:5616 LAWNDALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023-3840
Practice Address - Country:US
Practice Address - Phone:713-926-8899
Practice Address - Fax:713-923-7000
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX147451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice