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General NPI Number Information
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NPI Number | 1780189142
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Entity Type | Organization
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Legal Business Name | BASEWAVE PROPERTIES, PLLC
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 03/28/2018
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Provider Practice Location Address
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Address Line | 4808 FAIRMONT PKWY #404
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City | PASADENA
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State | TX
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Zip | 77505
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Country | US
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Telephone | 832-532-0863
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Fax | 281-754-4278
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Provider Business Mailing Address
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Address Line | 4808 FAIRMONT PKWY # 404
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City | PASADENA
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State | TX
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Zip | 77505-3722
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Country | US
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Telephone | 832-532-0863
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Fax | 281-754-4278
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | CLARIAN CARRINGTON
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Credential |
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Telephone | 832-532-0863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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