Healthcare Provider Details

I. General information

NPI: 1073205902
Provider Name (Legal Business Name): TREVOR JULIAN BASSETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 82ND ST
LUBBOCK TX
79423-2065
US

IV. Provider business mailing address

3210 OAKRIDGE AVE
LUBBOCK TX
79407-1853
US

V. Phone/Fax

Practice location:
  • Phone: 806-743-7800
  • Fax: 806-743-7651
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW5264
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: