Healthcare Provider Details

I. General information

NPI: 1780606400
Provider Name (Legal Business Name): PAUL S BASSEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 W FM 544 STE 250
MURPHY TX
75094-4626
US

IV. Provider business mailing address

511 W FM 544 STE 250
MURPHY TX
75094-4626
US

V. Phone/Fax

Practice location:
  • Phone: 469-800-2060
  • Fax: 469-800-2069
Mailing address:
  • Phone: 469-800-2060
  • Fax: 469-800-2069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ2926
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: