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NPI Code Detail

MEDICARE: DR. JASON L. BASILE DC

MEDICARE:  DR. JASON L. BASILE  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor7968TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1609133OTHERTXMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2605887OTHERTXBLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number : 1881879278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON L. BASILE DC
Provider Business Mailing Address
First Line : 5701 WOODWAY DR
Second Line : SUITE 225
City : HOUSTON
State : TX
Zip : 77057-1515
Country : US
Telephone Number : 713-532-2555
Fax Number : 713-532-2999
Provider Business Practice Location Address
First Line : 5701 WOODWAY DR
Second Line : SUITE 225
City : HOUSTON
State : TX
Zip : 77057-1515
Country : US
Telephone Number : 713-532-2555
Fax Number : 713-532-2999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 04/18/2008

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Directions to “ DR. JASON L. BASILE DC” Practice Location

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