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General NPI Number Information
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NPI Number | 1598572307
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Entity Type | Organization
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Legal Business Name | BASIN EYE SURGERY, LP
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 4222 WENDOVER AVE STE 800
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City | ODESSA
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State | TX
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Zip | 79762-5915
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Country | US
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Telephone | 432-280-4008
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Fax | 432-280-4028
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Provider Business Mailing Address
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Address Line | PO BOX 12256
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City | ODESSA
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State | TX
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Zip | 79768-2256
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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 | OPHTHALMOLOGIST / PRACTICE OWNER
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Name | DR. LAURA FARBER
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Credential | MD
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Telephone | 432-280-4008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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