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General NPI Number Information
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NPI Number | 1881084911
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Entity Type | Individual
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Provider Name | BASEM JUMAA CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 25440 INTERSTATE 45 N
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City | SPRING
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State | TX
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Zip | 77386
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Country | US
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Telephone | 281-602-8160
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Fax | 469-283-2743
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Provider Business Mailing Address
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Address Line | 3140 LEGACY DR STE 300
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City | FRISCO
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State | TX
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Zip | 75034-9383
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Country | US
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Telephone | 972-954-1469
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Fax | 469-283-2743
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP127313
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License Number State | TX
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