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General NPI Number Information
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NPI Number | 1164432746
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Entity Type | Organization
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Legal Business Name | BASIN ORTHOPEDIC SURGICAL SPECIALISTS, P.A.
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 1 PARKS LEGADO CT
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City | ODESSA
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State | TX
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Zip | 79765-2542
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Country | US
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Telephone | 432-332-2663
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Fax | 432-337-0910
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Provider Business Mailing Address
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Address Line | 1 PARKS LEGADO CT
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City | ODESSA
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State | TX
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Zip | 79765-2542
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Country | US
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Telephone | 432-332-2663
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Fax | 432-337-0910
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | GUYLENE MCNEAL SANDERS
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Credential |
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Telephone | 432-332-2663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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