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General NPI Number Information
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NPI Number | 1215236351
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Entity Type | Organization
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Legal Business Name | BASILEIA GROUP, INC
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Dates
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Enumeration Date | 03/15/2011
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 1102 PINEMONT DR STE F
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City | HOUSTON
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State | TX
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Zip | 77018-1323
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Country | US
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Telephone | 713-263-7680
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 PINEMONT DR STE F
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City | HOUSTON
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State | TX
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Zip | 77018-1323
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Country | US
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Telephone | 713-263-7680
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Fax | 713-263-7685
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. CARLOS HEATH
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Credential | PHARM.D
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Telephone | 713-263-7680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 25684
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License Number State | TX
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