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General NPI Number Information
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NPI Number | 1093945156
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Entity Type | Organization
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Legal Business Name | BASIN CARDIOTHORACIC & VASCULAR SURGERY ASSOCIATES
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 3001 W ILLINOIS AVE SUITE 1A
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City | MIDLAND
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State | TX
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Zip | 79701-3180
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Country | US
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Telephone | 432-682-2191
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Fax | 432-682-1707
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Provider Business Mailing Address
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Address Line | PO BOX 5293
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City | MIDLAND
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State | TX
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Zip | 79704-5293
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Country | US
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Telephone | 432-686-6600
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Fax | 432-682-2284
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Authorized Official
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Title or Position | CEO
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Name | MRS. RHONDA BURKE
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Credential |
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Telephone | 432-686-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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