Healthcare Provider Details

I. General information

NPI: 1801875273
Provider Name (Legal Business Name): KATHLENE E BASSETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 02/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 DATAPOINT DR SUITE 500
SAN ANTONIO TX
78229-5907
US

IV. Provider business mailing address

333 N SANTA ROSA ST
SAN ANTONIO TX
78207-3108
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-0180
  • Fax: 210-566-5698
Mailing address:
  • Phone: 210-704-2937
  • Fax: 210-704-4527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberH9782
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: