MEDICARE: LAS COLINAS ENDOCRINOLOGY

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1891286738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS COLINAS ENDOCRINOLOGY

Provider Business Mailing Address
First Line	:	210 W JOHN CARPENTER FWY STE 100
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-2003
Country	:	US
Telephone Number	:	469-291-0770
Fax Number	:	888-443-9001

Provider Business Practice Location Address
First Line	:	210 W JOHN CARPENTER FWY STE 100
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75039-2003
Country	:	US
Telephone Number	:	469-291-0770
Fax Number	:	888-443-9001

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. SAMATA BASANI
Credential	:	MD
Telephone Number	:	214-263-2627

Provider Enumeration Date	:	05/26/2018
Last Update Date	:	02/06/2026

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Directions to “LAS COLINAS ENDOCRINOLOGY ” Practice Location

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