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General NPI Number Information
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NPI Number | 1548454424
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Entity Type | Organization
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Legal Business Name | ROBERT L BASS MD PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 4461 COIT RD SUITE 107
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City | FRISCO
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State | TX
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Zip | 75035-0521
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Country | US
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Telephone | 972-712-9408
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Fax | 972-712-4493
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Provider Business Mailing Address
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Address Line | 4461 COIT RD SUITE 107
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City | FRISCO
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State | TX
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Zip | 75035-0521
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Country | US
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Telephone | 214-239-4500
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Fax | 214-239-4504
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | TAMMIE MARIE JACKSON
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Credential |
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Telephone | 214-239-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | H6036
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License Number State | TX
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