Provider Demographics
NPI:1679872188
Name:NAZARIAN, ALBRIK (DDS)
Entity Type:Individual
Prefix:
First Name:ALBRIK
Middle Name:
Last Name:NAZARIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:ALBRIK
Other - Middle Name:
Other - Last Name:NAZARIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6430 RICHMOND AVE
Mailing Address - Street 2:STE # 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5917
Mailing Address - Country:US
Mailing Address - Phone:713-621-7777
Mailing Address - Fax:713-785-0848
Practice Address - Street 1:6430 RICHMOND AVE
Practice Address - Street 2:STE # 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5917
Practice Address - Country:US
Practice Address - Phone:713-621-7777
Practice Address - Fax:713-785-0848
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15195122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX800622716Medicaid