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General NPI Number Information
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NPI Number | 1639742323
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Entity Type | Organization
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Legal Business Name | BASION SURGICAL SERVICES, LLC
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 6429 MOODY OAKS
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City | ALEXANDRIA
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State | LA
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Zip | 71301-2777
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Country | US
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Telephone | 214-356-4233
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12351
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City | ALEXANDRIA
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State | LA
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Zip | 71315-2351
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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 | BUSINESS MANAGER
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Name | MR. ROBERT JAMES HUDAK II
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Credential |
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Telephone | 972-666-0112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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