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General NPI Number Information
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NPI Number | 1053463596
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Entity Type | Organization
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Legal Business Name | BASALDUA & HELLER FAMILY PRACTICE
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 22999 HIGHWAY 59 N SUITE 272
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City | HUMBLE
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State | TX
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Zip | 77339-4412
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Country | US
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Telephone | 281-465-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 22999 HIGHWAY 59 N SUITE 272
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City | HUMBLE
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State | TX
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Zip | 77339-4412
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | YVONNE ZEIGMAN
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Credential |
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Telephone | 281-465-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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