MEDICARE: DR. ELIZABETH BASLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	HO163	TX

General Provider Information

NPI Number	:	1689668394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH BASLER MD

Provider Business Mailing Address
First Line	:	7505 SOUTH MAIN
Second Line	:	SUITE 530
City	:	HOUSTON
State	:	TX
Zip	:	77030-4524
Country	:	US
Telephone Number	:	713-799-1129
Fax Number	:	713-799-1023

Provider Business Practice Location Address
First Line	:	7505 SOUTH MAIN
Second Line	:	SUITE 530
City	:	HOUSTON
State	:	TX
Zip	:	77030-4524
Country	:	US
Telephone Number	:	713-799-1129
Fax Number	:	713-799-1023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	07/11/2007

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