Provider Demographics
NPI:1740207604
Name:NASUHOGLU, CEM (MD)
Entity type:Individual
Prefix:
First Name:CEM
Middle Name:
Last Name:NASUHOGLU
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 1:850 TOWER DR
Mailing Address - Street 2:SUITE #110
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4238
Mailing Address - Country:US
Mailing Address - Phone:432-332-0052
Mailing Address - Fax:432-332-8082
Practice Address - Street 1:850 TOWER DR
Practice Address - Street 2:SUITE #110
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4238
Practice Address - Country:US
Practice Address - Phone:432-332-0052
Practice Address - Fax:432-332-8082
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15688R208000000X
TXM1256208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics