Provider Demographics
NPI:1811978901
Name:NAGHAVI, NANCY (DO)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:NAGHAVI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NASIM
Other - Middle Name:OLYAE
Other - Last Name:NAGHAVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3919 FRY RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6731
Mailing Address - Country:US
Mailing Address - Phone:281-646-2273
Mailing Address - Fax:281-646-9511
Practice Address - Street 1:3919 FRY RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6731
Practice Address - Country:US
Practice Address - Phone:281-646-2273
Practice Address - Fax:281-646-9511
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34013170207Q00000X
TXL3764207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH525110OtherMEDICARE
TX166631501Medicaid
OH1841239274OtherPARTNERS PHYSICIAN GROUP NPI
OH0274149Medicaid