Provider Demographics
NPI:1962691055
Name:NASIR, RAJA N (DDS,MSD)
Entity type:Individual
Prefix:
First Name:RAJA
Middle Name:N
Last Name:NASIR
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 AUGUSTA DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2062
Mailing Address - Country:US
Mailing Address - Phone:713-781-4457
Mailing Address - Fax:
Practice Address - Street 1:1011 AUGUSTA DR
Practice Address - Street 2:SUITE 203
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057
Practice Address - Country:US
Practice Address - Phone:713-781-4457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics